JP2021045651A - Implantable lubrication device for treating human or mammal patient - Google Patents

Abstract

To provide a lubrication device for lubricating a joint of a human or a mammal patient, which is entirely implantable in the patient's body, where the device comprises a reservoir for storing a lubricating fluid and a fluid connection tube for introducing the lubricating fluid into the joint when the device is implanted in the patient's body; where the fluid connection tube comprises a fluid connection device connecting the reservoir with the joint such that a lubricating fluid flow is established from the reservoir into the joint.SOLUTION: A fluid connection tube comprises either an infusion needle adapted to be intermittently placed in a joint for causing an injection needle to inject the lubricating fluid, or a tube adapted to be permanently placed in the joint for continuously injecting the lubricating fluid.SELECTED DRAWING: Figure 1

Description

The present invention relates to implantable lubricators that lubricate joints of human or mammalian patients, implantable lubricators and methods of treating human or mammalian patients with said implantable lubricators.

The present invention is particularly suitable for the permanent introduction of lubricating fluids in joints, especially for the introduction of lubricating fluids on the basis of long-term or periodic publications that are permanent over many years, eg, long time intervals. There is.

The lubricating fluid (synovial fluid) reduces friction between the articular cartilage and other tissues of the joint and lubricates and protects the tissue components of the bone and joint during exercise. If the lubricating fluid is negatively affected and / or the joint articular cartilage that normally covers the joint bone is damaged, in most cases earlier age and / or human or mammalian joints (eg, hip joints, etc.) Due to the continued large or abnormal load on the hip joint), this can result in osteoarthritis (also known as osteoarthritis) characterized by painful inflammation of the joint. In response to pathological reduction and changes in the composition of the lubricating fluid in the communal space (consisting of the articular formation surface of the adjacent bone, which is stable and has joints contained by the co-capsule and synovial membrane) Thus, the lubricating fluid can no longer perform its normal work (ie, communal area and shock absorption lubrication) with the articular cartilage.

If the articular cartilage is also highly damaged due to osteoarthritis, etc. and / or is altered in its composition, the synovial fluid is diminished or less likely to drop friction into the contacts. The articular surface was dependent on high friction and increased the wear that caused the painful inflammation of the joints. This can result in serious restrictions on exercise, especially when walking and standing. And it further increases the method of deformability of the joint. Osteoarthritis is very common in the western world for this disease, which is a major cause for chronic disorders in Europe and the United States.

Patients with osteoarthritis are affected by the lubricating fluid (on the one hand, they restore the physiological correlation of the injurious joint as much as possible, and on the other hand, they contain as little extra stress as possible for the patient-physical. Requires regular long-term treatment introduced in (psychologically).

A well-known standard treatment is the periodic in vitro injection of synthetic lubricating fluid into a common space with a syringe to replace the absent physiological lubricating fluid. In this type of conventional treatment, it is inconvenient for the patient to drain the lubricating fluid through the syringe into the joint at regular time intervals with the skin and co-capsules. It may also cause damage to the skin and communal capsules. And it increases the risk of high-grade infections of delicate joint tissues. Therefore, infusions may not be performed more often than every six months.

However, many patients more often require replenishment of the lubricating fluid (ie, a small amount of continuous replenishment of the lubricating fluid).

The object is therefore supposed to propose improved techniques between lubrication, injurious or worn out, on the one hand, sufficiently oiling the joints, and on the other hand, minimal infections. Joints among at-risk human or mammalian patients.

Implantable lubricators, at a minimum, first introduce a reservoir that stores the lubricating fluid and secondly, when the lubricator is inserted into the patient's body, introduce the stored lubricating fluid into the injurious joint. It consists of a fluid connection pipe. The lubricating device can be fully inserted into the patient's body so that the injuring joint can be properly lubricated from the patient's body after surgery. This significantly reduces the risk of infection for the patient and allows post-skilled workers, continuously, intermittently, periodically, or as needed, eg, in contacts. Injury by fluid level Lubrication for joints Supply in fluid.

The planted lubricator according to the present invention comprises a planted lubricator and a lubricating fluid stored in its reservoir that is introduced into the joint by its fluid connection pipe.

Implantable lubricator (eg storage, pump or motor, energy source, controller)
Deeper coercion or any component of the may be done entirely within the patient's body. This type of component may belong to the implantable infusion device or may form an integral part of the implantable lubrication device that is separate from the actual implantable infusion device. Because the implantable lubricator is fully implantable in the patient's body, that is, the implanted lubricator has a function to preserve and lubricate the patient's body (a common lie within the patient's body). Provides the ability to carry the lubricating fluid within the complete flow path of the lubricating fluid for. Therefore,
There is no longer a need for extracorporeal injection into the joint.

The fluid connection tube consists of a fluid connection device that connects the reservoir of the implantable infusion device to the joint.
In this way, the joint establishes a flow path for the lubricating fluid from the reservoir. The fluid connection device is also fully implantable and preferably also consists of a flexible tube or the like. It is then suitable after surgery to carry the lubricating fluid stored in the reservoir to the joint.

Further, the fluid connection pipe is provided with an injection member connected to the fluid connection device. The infusion member may be introduced into the joint during surgery or into the body of a patient with close ties internally. Then, after surgery, the lubricating fluid can be introduced into the joint. Intermittent injection of lubricating fluid into the joint may be arranged, for example periodically, or if the fluid level falls below a predetermined threshold, depending on the action by the drive mechanism, for example, and , Relies on sensor data. Alternatively, and preferably, the injection member may also be arranged to continuously inject the lubricating fluid into a joint, eg, a predetermined amount of lubricating fluid per hour device, eg, a drop in hourly. ..

Intermittent or periodic injections are applied to the joint during surgery so that it may intermittently advance to the joint in the correct position after surgery and may then be retracted by the drive mechanism. It may be accomplished, for example, by an injection needle placed in close contact. Thereby, intermittent lubrication of the joint by the tip end of the injection needle is allowed. The drive mechanism is configured to be willing to contract the tip end of the injection needle to and from the joint. It is nevertheless placed as an integral part of the implantable lubricator so that it is completely implanted in the patient's body while the drive mechanism may be separate from the injection needle and / or fluid connector. ..

Alternatively, the injection member may consist of an injection tube that is permanently placed in the joint to continuously introduce the lubricating fluid into the joint. In this case, a separate drive mechanism for advancing / retracting the injection needle is not required. This is because of the following. The injection tube may, or may not be, be in a fairly soft material that does not interfere with the normal operation of the joint. Therefore, the injection tube may be located within a permanent foundational contact. The lubricating fluid may then be continuously inserted into the communal space.

Preferably, the reservoir of the implantable lubricator consists of a reservoir connected to a fluid connection device for storing the lubricating fluid. Generally, the oiling liquid is contained in the reservoir. The reservoir may be located as a separate part of the implantable lubricator. And it must be separately implanted in the patient's body. To establish a proper fluid flow of the lubricating fluid in the joint, the reservoir trades its volume with creating sufficient pressure within the fluid connection device and injection member to carry the lubricating fluid to the joint. May adapt for.

Thus, at least some perimeters of the reservoir are flexible as the lubricating fluid is filled or drawn into the reservoir and from the reservoir to the joints by the fluid connection device to cause fluid flow. It may consist of a flexible outer wall for varying the amount of storage due to material deformation.

Thus, the reservoir may be in a balloon type. The flexible material may consist of a polymer membrane. Bellows structures are preferred with pre-curved wrinkles to reduce long-term decline. Drawing liquid from the reservoir to the fluid connection and to the joint is stored so that negative pressure is achieved compared to the pressure in front of the injection needle or the injection tube at the joint end of the fluid connection. May cause a decrease in pressure applied to the smallest part of the part.

The reservoir may also have a replenishment infusion port for replenishing the planted reservoir with oiling the liquid from outside the human body. The reservoir inserted into the patient's body in addition to the fluid connection device may be kept thus small from the time the reservoir could be easily replenished at appropriate time intervals. Preferably, the infusion port is made of a self-sealing material with respect to the penetration produced by the replenishing syringe typically used to replenish the patient's skin reservoir. It is preferable, or at least, to plant a reservoir of lubrication equipment.
The self-sealing infusion port of the reservoir is the body in the patient subcutaneously so that it is easily accessible for replenishment by the syringe.

The reservoir may be manually compressed to introduce a fluid or infusion tube into the patient's joint with a fluid connection device and an infusion needle, which connects the pump to the fluid connection device to connect the reservoir and joint. It is preferred to connect it to the injection member for pumping the lubricating fluid from the reservoir. It is easy to measure the exact amount of lubricating fluid with a pump and thereby supply the appropriate amount of lubricating fluid to the joints in a continuous or intermittent manner.

Preferably, the implantable pump has a smooth surface layer facing each other to form a sealing contact between the valve device having the first and second valve members and the first and second valve members, respectively. With the above-mentioned first and second valve members of the above, different liquid channels that have a deeper depth that can be brought into the array by replacing the two smooth surface layers in relation to each other while maintaining a sealed contact. And. This type of pump is WO 2004/01/
2806 A1 is described in great detail. The first and second valve members are preferably made of many materials from ceramic materials due to their excellent sealing ability over a long period of time and their inactivity. The pump may be a membrane type pump, as described in WO 2004/012806 A1 (restricted to this type of pump).
As the piston moves, the membrane type pump may consist of a membrane that can be replaced by the piston. The piston is then connected to the valve device to slidably move the first and second valve members in relation to each other as the piston moves.

Preferably, the manual actuation of the pump or drive mechanism results in the actuation of the other (ie, drive mechanism or pump) at the same time. For example, the pressure established by the pump may advance the injection needle into the drive mechanism, and when the injection fluid is expelled to the patient's body by the tip end of the needle, the pump pressure rescue causes a return spring or Other powerful means can store the injection needle.

The implanted pump is placed by a pressure sensitive switch to be manually operable when implanted subcutaneously in the patient's body by a mechanical remote controller, or by a measured fluid level. If drops below a predetermined threshold, the fluid level of the joint is measured and the pump (and the drive mechanism for the development and / or contraction of the injection needle) is activated by a sensor mechanism that activates the pump. May work. Preferably, the actuation of the pump or drive mechanism results in the actuation of the other (ie, drive mechanism or pump) at the same time. For example, the pressure established by the pump may advance the injection needle into the drive mechanism, and the pressure rescue of the pump when the oiling liquid is expelled into the patient's body by the tip end of the injection needle. Allows a return spring or other powerful means to retract the injection needle.

Inject needle into to actuate the pump and, if utilized, to proactively and / or cause a lubricating fluid flow directly or indirectly to the joint within the range of the lubrication device. The drive mechanism for storing / out may be provided by a minimalist motor. The moving ones are for actuating the pump and / or drive mechanism electrically, eg, magnetically or electromagnetically, or hydraulically actuating the pump and / or drive mechanism. .. Preferably, the motor is arranged to operate the pump or drive mechanism. This causes the other (ie, drive mechanism or pump) to operate simultaneously. The motor may also be provided for invoking any other energy-consuming part of the infusion device.

The condition "motor" in the sense of the present invention includes anything that uses energy driven by the other than the manual, and also automatically converts this kind of energy into motion or hydraulic energy, or other types of energy. Alternatively, this type of energy is used to directly activate the pump, drive mechanism and / or other parts of the planted oiling device. Thus, for example, in the case of an electromagnetically actuated drive mechanism, the drive mechanism portion may also form the motor portion.

The motor is formed into a portion of the lubricating device and is inserted within the body of the anointing device and another patient's body within the range of the patient's body or of the lubrication device. Included in the body. Coupling elements may be provided on the motor either for conduction outside the device or for radio energy transfer. For example, a motor may be arranged to be driven wirelessly by an external electromagnetic field. It is also possible to use an external energy source, especially the rechargeable battery outside the patient's body (eg major energy source or battery) (the patient's skin and / or the patient's skin that supplies energy to the pump and / or drive mechanism). Place it on any other energy-consuming part of the lubricator). Especially the energy source may be connected to at least one motor to operate these parts. External energy sources for wireless energy transfer may be adapted to create external fields (eg, electromagnetic fields, magnetic fields or electric fields) or generate wave signals (eg, electromagnetic or sonic signals).

Where the energy is wirelessly transferred to the planted lubricator, a transformer forming device may be installed that converts the wirelessly transferred energy into electric energy. This type of converter is preferably adapted because it is placed directly under the patient's skin to minimize the distance and amount of tissue between the converter and the energy supply means outside the patient's body. To do.

Energy transfer devices for wireless energy transfer from energy sources and / or energy storage means to converters may be adapted to generate electromagnetic fields. Alternatively, or in addition, energy transfer devices for wireless energy transfer may be adapted to generate a magnetic field. Also, energy transmission devices for wireless energy transfer may be adapted to generate an electric field. Radio energy may be transmitted by an energy transmitter by at least one wave signal. This type of signal may consist of an electromagnetic signal. And X-ray radiation, including at least one of an infrared light signal, a visible light signal, an ultraviolet light signal, a laser signal, a microwave signal, and a radio signal, sends a signal, and
-Radiation signal. Also, the wave signal may consist of a sound or ultrasonic signal. Furthermore, radio energy may be conducted as a digital or analog signal or a combination thereof.

Instead of or in addition to an external energy source, the implantable lubricator may have its own energy source. This type of energy source is an oiling device that may be part or contained within the body. However, it may also be a provided reprint from the body of the device oiling the remote transplant within the patient's body.

Preferably, this type of implantable energy source is provided with energy storage means, such as a long life battery or, more preferably, an accumulator. The accumulator has the effect of being rechargeable. Preferably, the accumulator consists of a rechargeable battery and / or capacitor.

Also, when the device is inserted into the patient's body, the accumulator is charged from outside the patient's body, either as a conduction from a major energy source outside the device to the accumulator or a coupling element for radio energy transfer. May be provided. Similarly, the accumulator may consist of a coupling in which elements for conduction and / or radio energy supply at least one motor of the infusion device.

While at least one motor may be equipped with actuating means for manual activation of the motor, it is also preferred to provide a control device to control at least one motor. The control device may also be used to control the pump, drive mechanism and / or any other energy-consuming part of the planted oiling device, the device being internal. It may even be used to control this type of energy source, or wherever it contains an external energy source. The control device may meet the individual needs of the patient. Then, the appropriate amount of medicine is managed at appropriate time intervals. Automatic management effectively saves the patient.

Preferably, the control is the patient, regardless of whether the control is contained within the body of the lubricator or whether it is implanted within the patient's body far from the body of the lubricating device. It has a data transfer port for data transfer between an external data processing device outside the body and a control device inserted into the patient's body. The data transfer port allows oversight of the control device to adapt the infusion device to changing the patient's needs. Preferably, the data transfer port is a wireless transfer port for data transfer in order to provide easy data exchange between the control device and the data processing device. For example during a PhD visit. Most preferably, the controller is programmable to further increase its adaptability.

Controls may also be provided externally-with or without data transfer ports. For example, it is attached to the patient's skin. The effect of the external controller is that it is easily accessible in the event of any failure. It is preferably adapted for wireless remote control of at least one motor inserted in the infusion device.

The control signal transmission device may be provided to the planted motor for wireless communication of extracorporeal control signals and the like. Similarly, a data transmission interface for wirelessly transmitting data from outside the patient's body to a control device inserted into the patient's body may be provided. Also, the radio control signal and / or data transmission may consist of someone with the wave signal described above. And it is digital, analog, or a combination thereof. More preferably, as energy is transmitted to the motor, control signals may be transmitted as well. For example, the control signal may be transmitted by modulation of the energy signal. The energy signal thus serves as a carrier signal for a digital or analog control signal. More specifically, the control signal may be a frequency, phase and / or amplitude modulated signal.

Feedback may be provided for relevant parameters for the treatment of the patient, away from or as part of the controller. This type of parameter may be any physical parameter of the patient and / or a process parameter of the device. Therefore, at least one feedback sensor is provided by detecting and providing this type of parameter. For example, a feedback sensor may detect the level of lubricating fluid within the range of joints or other parameters relating to the joint and its lubrication conditions. The feedback sensor may be connected to the controller, and the controller may consist of a control program for the control transmission of the lubricating fluid to the joint in response to one or more signals of the feedback sensor. .. In addition, or instead, feedback data may be transferred from the controller to an external data processing device. This type of feedback data may be useful for doctors' diagnosis.

Preferably, the fluid connection device comprises two fluid connections, each connected to a reservoir and having an injection member at its open end inserted into a common space. After surgery, they are via the joint, i.e. from the pump and / or reservoir to the joint (via the first fluid connection) and to the pump and / or reservoir (via the second fluid connection). The two fluid connections may be placed within the patient's body to form a circular flow path for the lubricating fluid. Under the pressure created by the flexible outer wall of the pump or reservoir
The lubricating fluid may circulate intermittently or continuously in a circular flow path. Then, the second fluid connection portion picks up the lubricating fluid in the common space fitted therein through the first fluid connection portion.

Due to the circular flow path, the lubricating fluid is at least partially reused after passing the joint, so the fluid is eventually polluted by impurities or other foreign particles that may reduce the quality and desired effect of the lubricating fluid. Is done. The circular fluid connection device of an implantable lubricator may therefore also consist of a filter device with a filter connected to a circular flow path to remove dirty particles from the polluted circulating lubricating fluid. Preferably, the filter device is adapted to clean the filter on a regular basis, and the removal of particles has leaked from the lubricating fluid. These removed impurities or foreign particles may then settle in a sealed sedimentary space or be returned to the patient's body, for example to surrounding tissues, or to blood vessels or the like.

The lubricating device may be inserted into the patient's body at various locations, preferably as close as possible to the injured joint to be lubricated. For example, it is possible to implant a femoral lubricator-or part of it-to lubricate the femoral ball or knee joint.
An oiling device or, for example, an oiling device having a fully filled reservoir as it may be difficult to replenish the abdominal reservoir when its reservoir is relatively large. Insertion may be preferred. However, a subcutaneously located replenishment injection port connected to the reservoir via a tube may be appropriate in this case. Or
The lubricator may also be inserted subcutaneously. If necessary, subcutaneous implantation increases the potential for radio energy and / or data transfer to and from the oiling device.
Also, when the oiling device is inserted subcutaneously, it is substantially easier to replenish the reservoir with the replenishment injection port with a replenishing needle that penetrates the skin with the patient's. Inserting a anointing device within the adipose tissue, depending on the individual treatment,
Lubricating fluid can be injected into a particular joint, which may be advantageous, or by intramuscular injection, or adjacent to the joint.

Apart from the lubrication device having its various elements described above, the implanted lubricator according to the invention is suitable for storage in the reservoir and adapted to be introduced into the joint by the implanted fluid connection tube. Consists of lubricating fluid. Preferably, the lubricating fluid is reabsorbable and biological to ensure phagocytosis and biological and chemical interactions of the synthetic lubricating fluid by the patient's body in the same manner as the physiological lubricating fluid. It is compatible. Preferably, the lubricating fluid is hyaluronic acid or the like.

In one embodiment where a implantable medical device is, at least a joint (the human body or mammal) that replaces at least one surface layer of at least two contact surfaces of the mammal (the medical device that further comprises). Adapted to lubricate the weight resulting in at least one artificial contact surface of the artificial contact surface (when planted in the body). And since at least one outlet has been adapted to receive the lubricating fluid, the reservoir, and the health checkup, which the device is, dispenses the oiled fluid from the reservoir and it Was adapted to be operable by an artificial fluid for transport to the at least one artificial contact surface.

The implantable medical device may include said reservoirs and joints that are spaced apart. It then consists of a conduit for fluid connection between the reservoir and the joint.

The implantable medical device may have a reservoir adapted to be placed subcutaneously, or consists of a group of areas selected from the body of the patient's area.
a. abdomen,
b. Inguinal region,
c. Pelvic area, and
d. Thigh area.

The implantable medical device may be placed in the abdomen in this way.

The replacement injection port may be suitable for subcutaneous implantation or may be related to bone.

Implantable medical devices may be adapted to lubricate one artificial contact surface and the opposite contact surface of the hip or knee joint of a human or mammalian patient.

It has a surface layer that provides a midline and lateral contact weight (the implantable medical device may be adapted to lubricate the artificial contact surface on the intermediate side of the knee joint of a human or mammalian patient. No) knee joint.

It has a surface layer that provides a midline and lateral contact weight (the implantable medical device may be adapted to lubricate the artificial contact surface on the lateral side on the knee joint of a human or mammalian patient. (Maybe) knee joint.

A mammalian joint with at least two contact surfaces. The medical device is adapted to lubricate at least one artificial contact surface with at least one surface layer of the mammalian joint contact surface returned to the joint. In addition, the medical device consists of at least one inlet adapted to receive the lubricating fluid from the reservoir.

Usually at least one channel is at least partially integrated in the artificial contact surface in association with at least one inlet for distributing the lubricating fluid to the surface of the artificial contact surface. Medical devices can be adapted because they can be operated by an operating device to dispense oiled fluid from the reservoir. The possibility of injecting lubricating fluid intermittently, or reducing the friction of the joint required, and allowing the optimum level of joint lubrication.

According to one embodiment of a implantable medical device, distributing a lubricating fluid to the surface layer of an artificial contact surface on two or more parts of the artificial contact surface for oiling the artificial contact surface is not possible. Can be adapted. The distribution of the plurality of parts can allow a more uniform distribution of the lubricating fluid.

According to other embodiments, the medical device adapted by the reservoir to retain the lubricating fluid, either subcutaneously or in connection with the bone, could be an implantable reservoir placed in the void of the body.

The implantable medical device can further consist of an operating device adapted to carry the lubricating fluid from the reservoir to the artificial contact surface for oiling the artificial contact surface.

According to one embodiment, the reservoir can be adapted to retain the lubricating fluid, and the operating device according to any of the embodiments herein is for oiling the artificial contact surface from the reservoir. It can be adapted to carry the lubricating fluid to the artificial contact surface.

The operating device can consist of a reservoir according to any of the examples herein. Then, it is preloaded by the pressurized lubrication fluid.

According to another embodiment, by injecting into an infusion port to preload a reservoir with pressurized lubricating fluid, the implantable medical device further comprises an injectable infusion port adapted to allow. Can be done.

The implantable medical device can further consist of a reservoir and a valve adapted to end the bond with the artificial contact surface, according to one embodiment. The reservoir can be adapted to be placed in a device separate from the artificial contact surface and can be adapted to be connected to an artificial contact surface having a duct. The reservoir could consist of a movable wall portion adapted to move and change the amount of reservoir, the wall portion could be a driven wall portion that could consist of a motor.

According to another embodiment, the implantable medical device can be integrated on an artificial contact surface and partially consist of at least one outlet and at least one deeper channel. Medical devices can be adapted to allow circulation of lubricating fluids;
Out of the artificial contact surface to the artificial contact surface by the outlet and by the inlet. Enclosing the fluid can be performed by an operating device adapted to circulate the lubricating fluid. The swirling system can consist of a reservoir adapted to add the fluid to the circulating lubricating fluid and / or a filter that cleans the circulating lubricating fluid.

The operating device according to any of the embodiments can be adapted to intermittently transport the lubricating fluid to an artificial contact surface.

A portable medical examination in which the device can do so according to one embodiment is a functional parameter of the operating device that controls the joint or pressure or lubricating fluid or operating device to align the flow of lubricating fluid to an artificial contact surface. Consists of sensors adapted to detect physical parameters inside the volume of the.

The reservoir according to any of the examples can be connected to an artificial contact surface by a conduit. To connect the duct to any part of the medical device, the inlet can consist of a connection. The conduit can consist of multiple parts according to any of the examples. And it can be adapted because it is connected to each by the interconnect. First of the conduit
A portion can be associated with a medical device, and a second portion of the conduit can be associated with a reservoir. Consistent with one example, the method of passage through the body bone for long-term storage is adapted to allow the lubricating fluid to reach the artificial contact surface and be recognized as open in the bone. be able to. Adapting to recognize that the duct is open in the joint capsule of the body for long-term storage by other embodiments, and the way of passage is open in the joint capsule,
The lubricating fluid can reach the artificial contact surface, and matching the duct to yet another embodiment is the acetabulum adapted to pass through the pelvis from the opposite, and said to the hip joint. Is.

The implantable medical device replaces the contact surface of the acetabulum or lubricates the hip joint of the patient and / or femoral head when the artificial contact surface of the medical device could at least partially adapt. Can be adapted for.

The implantable medical device can lubricate the second artificial contact surface according to one embodiment. To match the first artificial contact surface in one embodiment, a convex shape toward the center of the hip joint is provided, and the concave shape toward the center of the hip joint is provided on the second artificial contact surface. There is. The first artificial contact surface is consistent with the opposite embodiment adapted for fixation to the human patient's pelvis, and the second artificial contact surface is fixed to the human patient's femur bone. Adapt for.
From the abdominal side of the pelvis (the operational method by which the hip capsule can be fully retained), an artificial contact surface can be adapted to be introduced into the hip by a hole in the pelvis.

Reservoir One example can be adapted to be consistent, or at least partially inside the patient's bone, to be placed inside the bone, eg, the bone of the patient's femur, the pelvis or It could be the colon chimney femur.

According to other embodiments, the reservoir can be adapted to be placed subcutaneously, or in the void of the body (which could be the cavity of the region selected from the group of regions):
abdomen,
Inguinal region, pelvic region and thigh region.

The implantable medical device can consist of an injection port for filling in the reservoir according to one embodiment. The injection port can consist of a self-sealing membrane. And it could be, for example, a parylene coated silicone film. In connection with the bone or in the cavity of the body, the injection port can be adapted to be implanted subcutaneously.

The reservoir can be adapted to place the lubrication fluid under pressure. To achieve the pressure, the reservoir can be adapted to be a spring to be loaded, to consist of a chamber adapted to hold the compressed gas, or to consist of an elastic wall adapted to create the pressure. it can. A parylene-coated silicone rubber wall is provided to match the storage section to one embodiment.

A parylene-coated silicone rubber wall is provided to match the storage section to one embodiment. According to another embodiment, the implantable medical device is adapted to lubricate the patient's knee joint. Oiled Artificial Contact Surface A contact surface of femoral bone (which could be the contact surface of tibia and / or femoral bone) that can be partially adapted to match one example. Exchange.

According to one embodiment, the medical device is adapted to lubricate at least one of the mid- or lateral portions of the contact surface of the tibia of the knee joint, and according to another embodiment, the implant. Possible medical devices are adapted to lubricate at least one of the medial or lateral sections of the bone contact surface of the femur of the knee joint. In yet another embodiment, the medical device is adapted to lubricate the contact surface of the femoral bone of the knee joint and the contact surface of the tibial bone of the knee joint.

Adapting and replenishing the reservoir according to one of the embodiments by one example to be replenished from outside the human body can be performed at a implantable injection port.

According to one embodiment, the reservoir is adapted to maintain pressure. And it is possible to increase by injecting the lubricating fluid through the injection port.

The implantable medical device according to any of the embodiments can be adapted because it is part of the system. And it can further consist of at least one implantable switch in the patient between manually and non-invasively controlling the implantable medical device. The energized system allows the operating device to operate the lubrication performed by the medical device.

The system can further consist of a hydraulic system with an implantable fluid reservoir according to one embodiment. And it can be hydraulically connected to the implantable medical device. Implantable medical devices can be adapted for non-invasive adjustment by manually pressing the fluid reservoir.

According to other embodiments, the system can further consist of a wireless remote control device for controlling a non-invasively implantable medical device. The wireless remote control device can consist of at least one external signal transmitter and / or receiver. It further comprises an implantable internal signal receiver and / or transmitter in the patient for receiving the signal transmitted by the external signal transmitter or sending the signal to the external signal receiver. The wireless remote control device can be further adapted to transmit at least one radio control signal for controlling the implantable medical device. The radio control signal can consist of frequency (amplitude) or can carry out a modulated signal or a combination thereof in stages. Wireless remote control devices can be further adapted to send electromagnetic carrier signals to carry control signals.

According to another embodiment, the system energizes the implantable energy-consuming components of a implantable medical device that has non-invasive wireless energy-wireless energy-
It can consist of a transmission device. Radio energy can consist of wave signals. Then, it is selected from the following: sound wave signal, ultrasonic signal, electromagnetic wave signal, infrared light signal, visible light signal, ultraviolet light signal, laser light signal, microwave signal, radio wave signal, X-ray radiation signal, gamma radiation signal. , Electric fields, magnetic fields, compound electromotive objects and magnetic fields.

The control signal of the system can consist of an electric field, a magnetic field, a compound electromotive object and a magnetic field.
The signal can consist of an analog signal, a digital signal or a combination of analogs and digital signals. To drive the energy-consuming components of a implantable medical device, the implantable system can consist of an implantable internal energy source. According to another embodiment, the system consists of an external energy source for transferring energy in wireless mode. There, the internal energy source is rechargeable by the energy transferred in wireless mode.

According to a deeper embodiment, the system can further consist of sensors, or to request feedback information from an internal energy source (and a feedback device that sends feedback information to the outside of the patient's body). The measuring device detecting or measuring the functional parameters that correlate with the transfer of energy could be related to the functional parameters detected by the sensor or measured by the measuring device. ..

According to yet another embodiment, the system feeds back from inside the patient's body to feedback information relating to at least one of the patient's physical parameters and functional parameters associated with the implantable medical device. It can further consist of a feedback device that sends information.

Sensors and / or measuring devices and / or measuring devices for controlling implantable medical devices in response to information related to at least one of the patient's physical parameters detected by the sensor to match one example of the system. Implantable built-in controls can be further configured or accurately measured by measuring devices and functional parameters associated with implantable medical devices detected by sensors or measured by measuring devices. The physical parameter could be pressure or motility according to one example.

The system is consistent with the external data communicator (the communicator puts into the data related to the medical device or patient that is portable to the external data communicator and / or the external data communicator is the internal data communicator. It can consist of an external data communicator and a portable internal data communicator that communicates with the built-in data that is stored in the data.

The system according to any of the embodiments herein can further consist of a motor or a pump for operating a implantable medical device or a hydraulic operating device that operates the implantable medical device. The operating device was determined to be on a longer path, where the operating device could instead consist of servomotors designed to reduce the force required to operate the implantable medical device. An operating device that is increasing the time for movement.

According to one embodiment, the system can further consist of an operating device that operates a implantable medical device. As radio energy is transmitted by an energy-transmission device, the radio energy can be used in its radio state to drive the operating device directly to create kinetic energy for the operation of the implantable medical device.
The system can also consist of an energy converter for converting the radio energy transmitted by the energy-transmission device from the first form to the second form energy.

As the energy converter converts the first form energy transmitted by the energy-transmission device into the second form energy, the energy converter directly seconds.
It can be adapted to drive the implantable energy consuming components of implantable medical devices with the form energy of. The second form energy can consist of at least one of direct current, pulsating direct current and alternating current. The first or second form of energy is at least one magnetic energy, kinetic energy, solid energy, chemical energy, radiated energy, electromagnetic energy, photographic energy, nuclear energy thermal energy, non-magnetic energy, non-motion. It can consist of energy, non-chemical energy, non-sound energy, non-nuclear energy and non-thermal energy.

To protect the system or parts of the system, the system can further consist of an implantable electrical component that includes at least one voltage level guard and / or at least one constant current source guard. Control devices can be placed to control the transmission of radio energy from the energy-transmission device, and an implantable internal energy receiver to receive the transmitted radio energy, a recipient directly implantable medical care. Internal energy that could be connected to a component that is consuming the portable energy of the device or indirectly supplying energy to it, the system receives energy received by the internal energy receiver The control device can further consist of a decision device adapted to determine the energy balance between, and the energy is used for the implantable energy consuming component of the implantable medical device. Can be adapted to control the transmission of radio energy from external energy-transmission devices. Then, it is based on the energy balance measured by the determination device.

The determination device can be adapted to detect a change in energy balance, and the control device can be adapted to control the transmission of radio energy based on the change in detected energy balance. Judgment devices can be adapted one after another to detect the difference between the energy received by the internal energy receiver and the energy used for the implantable energy consuming components of the implantable medical device, and , The control device can be adapted to control the transmission of radio energy based on the detected energy difference.

The energy-transmission device is capable of continuously pulling and leading the radio energy between the leading edge of the electrical pulse and the human body (internally, to change what the force is with the transmitted radio energy. Electrical pulses that have and electrical pulses that transmit the trailing edge, electrical circuits that adapt to continuously lead and vary the first time interval between the trailing edge and / or the second time. Implantable energy one after another to be placed in connected human bodies and electrical circuits to drive spaced external coils.
Energy receivers receiving transmitted radio energy that can consist of coils placed externally (which can further consist of receivers) Variety of forces. The electric circuit
It can be adapted to eject an electrical pulse because it remains invariant except for varying the first and / or second time interval.

A time constant and a range of only the first that is consistently adapted to vary the first, such that the length of the first and / or second time interval varies, to match one example of the system. The transmission power on the coil, which can be an electrical circuit with a second time interval, is diverse.

Implantable internal energy receivers for receiving radio that energy can do so are an energy transmitter with a first coil and transmitting radio energy, an external second coil and a second coil (outside the energy transmitter). The second coil is connected to the energy receiver, which transmits the radio energy received by the first coil).
The connection of the internal first coil to the system force on / off, which consists of the internal first coil connected to the external energy transmitter for the electronic circuit and the first electronic circuit, is the first.
The feedback information associated with entrusting the switch to the first coil to transfer to the electronic circuit of the external second coil is now received by the external energy transmitter in the form of impedance changes in the cargo of the external second coil. At that time, the power switch shifts the connection of the internal first coil to the first electronic circuit on / off.

The system can also consist of an implantable internal energy receiver for receiving radio energy, an energy receiver with an internal first coil and a first electronic circuit connected to the first coil, and radio. An external energy transmitter for conducting energy, an energy transmitter having an external second coil and a second electronic circuit were connected to the second coil. There, the external second coil of the energy transmitter transmits the radio energy received by the first coil of the energy receiver, and the system further consisting of the feedback device that transmits the amount of energy to the outside is the first feedback information. The amount of energy received in the first coil and the second electronic circuit receives in the first coil to receive feedback information and to obtain a coupling factor between the first and second. A coil comprising a determination device for comparing the amount of energy transferred by a second coil having relevant feedback information.

In an embodiment where the system consists of an external second coil, the external second coil can be adapted to move with respect to the internal first coil to establish optimal installation of the second coil. There, the coupling factor is maximized. The external second coil can also be adapted to adjust the amount of energy transferred to accomplish the feedback information in the determination device. After that, the coupling factor is maximized.

According to the second aspect, a method of inserting the medical device according to any of the examples in the present specification is further provided. The method provides the following steps. Reaching the joint from the outside of the human body, providing the joint with an artificial contact surface, fixing the artificial contact surface to the joint, inserting the reservoir into the human body, included in the reservoir Lubricating fluid is used to create an oiling opening in the artificial contact surface.

The step of lubricating a joint or artificial contact surface with the lubricating fluid contained in the reservoir consists of inserting an operating device adapted to transport body fluid from the reservoir to the artificial contact surface. be able to. Another embodiment is provided to provide an energy source for driving the operating device to match the step of lubricating the artificial contact surface with the lubricating fluid contained in the reservoir.

According to yet another embodiment, the step of lubricating a joint or artificial contact surface with the lubricating fluid contained in the reservoir consists of driving an operating device using an energy source. be able to.

The step of inserting the storage unit into the human body can consist of the step of inserting the operating device integrated in the storage unit according to a person's embodiment. It then allows the step of lubricating the artificial contact surface with the lubricating fluid contained in the reservoir. Then, an operating device that transports the fluid from the storage unit to the artificial contact surface is used.

Inserting the reservoir and matching any of the examples can consist of at least partially inserting the reservoir into the patient's bone. And it could be the bone of the patient's femur, the bone of the patient's tibia and / or the patient's pelvis.

The step of providing the artificial contact surface can consist of the step of providing the artificial contact surface from the abdominal side of the pelvis.

The step of inserting the reservoir into the human body can consist of the step of inserting the reservoir subcutaneously. Placing the reservoir subcutaneously allows simple access to and from the reservoir, eliminating the need for a long conduit between the infusion port and the reservoir.

The step of inserting the reservoir under the skin can consist of implanting the reservoir in at least one of the patient's areas selected from a group of areas: abdomen, groin,.
Pelvic area, thigh area and calf leather area.

A deeper step of planting an injection port to fill in the reservoir can be performed. Implantation of the infusion port can consist of the steps of implanting the infusion port in association with the bone.

According to one embodiment, the medical device consists of an artificial contact surface adapted to bring the weight of the patient's joint, the artificial contact surface can consist of at least one channel for carrying the lubricating fluid. The method was adapted to insert a medical device consisting of the following steps into a human patient's joint and insert a conduit because it is connected to the medical device. Then, insert an operating device that carries the lubricating fluid inside the conduit, insert a reservoir that is adapted to keep the lubricating fluid, and at least from the reservoir to the conduit, and
Furthermore, after surgery to the artificial contact surface by the channel of the artificial contact surface, by the operating device,
Lubricating fluid was transported. Thereby, a lubricating fluid was applied to the artificial contact surface.

Usually, the lubrication device may be inserted during conventional surgery or by endoscopic or laparoscopic methods.
In addition, one must distinguish between methods of inserting a lubricator with a method of inserting a lubricator with an injection needle for the intermittent introduction of the lubricating fluid and an injection tube for the continuous introduction of the lubricating fluid. It doesn't become.

In methods of treating human or mammalian joints (eg, human hip or knee osteoarthritis) by supplying lubricating fluid to the joints with an implantable lubricator, the appropriate location, including the area of the joints, is surgically in the patient's body. Freely incised. And it may involve cutting the patient's skin in particular and making an incision in the reservoir at the appropriate place for the lubricating fluid to enter.
The lubricator is then placed in a suitable, open incision, in such a way that the fluid connection tube may introduce lubricating fluid into the joint after surgery.
For this purpose, a hole is made in a communal capsule in the incised free area of the joint, and the open end of the injection tube continuously injects the joint with lubricating fluid stored in the reservoir after surgery. To be placed in continuous communication with joints in
The injection tube is introduced into the hole.
That is, firstly, the injection tube is fitted into the hole so that the opening end of the injection tube is kept in permanent communication with an oiled joint, and secondly, the injection tube is It is in contact with the fluid connection device and thus in the reservoir.
After installation of the lubricator, the patient's body closes so that the lubricator is fully inserted into the patient's body.
This process may be preferably performed in layers and by means of suturing or staples or adhesives and the like.
Finally, after the transplantation process, the lubricating fluid is introduced into the reservoir after surgery so that the joints are properly lubricated by the operation of the implanted lubricator.

Alternatively, if the fluid connection tube consists of an injection needle that is intermittently operated as an injection member, the installation of a lubricator at an appropriate position and area where the joint is incised is an intermittent injection needle drive mechanism. Achieved by arranging an injection needle of this kind with respect to the incised area of the joint, which may be introduced and may be stored,
The into / out of the joint in which this type of lubricating fluid is stored in the reservoir is intermittently injected into the joint.
That is, while it intermittently lubricates the joint, it may do so by the appropriate drive mechanism connected to the drive mechanism, and then by what is introduced into the retracted joint, etc. The injection needle is placed in close contact with the incised free area of the joint.

Another method of treating a human or mammalian patient with an implantable lubricator is endoscopic or laparoscopic technology to create an area of the joint where the lubricating fluid may be injected into the joint by the infusion member. Use for.
First, this area of the joint is to fit a needle-like or tube-like instrument into the patient's body to fill the tissue with gas, thereby inflating the void near the joint. n
It is provided by inflating a closely related cavity into a joint by introducing gas with an edle / tube-like device.
After that, at least two laparoscopic / endoscopic trocars are placed in the cavity, and the camera and at least one incising tool are fitted with laparoscopic trocars.
The area of the joint is incised with the incising tool then inserted.
Also, suitable locations for the remaining components of the lubricator are freely incised (eg, reservoirs, pumps or motors, etc.).
The lubrication device is then placed in place, but the fluid connection tube with the infusion member is placed in the laparoscopically incised area of the joint so that the lubricating fluid is introduced into the joint.
After installation of the lubricator, the patient's body is closed to the effect that the lubricator is completely inserted into the patient's body.
The lubricating fluid can then be introduced into the reservoir after surgery so that the joint is properly lubricated by the fluid connection device and injection member.

Lubricating devices using laparoscopic methods and also having an injection tube or needle may be inserted.
In the former case, the reservoir is placed in place, the hole is made in a communal capsule in the laparoscopically incised area of the joint, and the open end of the tube is the joint and the stored lubrication. The injection tube is fitted into the hole so that being placed in continuous communication with fluid may be continuously injected into the joint.
In the latter case, after placing the reservoir in place, the injection needle is intermittently injected into (and from) the joint so that the lubricating fluid containing the drive mechanism can be injected intermittently into the joint. The injection needle and drive mechanism are placed in close contact with the laparoscopically incised area of the joint so that it may be introduced (and retracted).

Closing the patient's body or especially the skin may include suturing, tape recording, and other suitable techniques, for example.
The lubrication device may be placed subcutaneously in the patient's body or within the area of adipose tissue, or by intramuscular injection.
If appropriate, the lubricator may also be placed in or adjacent to the patient's gastrointestinal or urinary area.
When it is placed adjacent to the tract, it may stick to the gastrointestinal or urinary tract by a retainer connected to the lubricator.
Alternatively, the lubrication device may be placed in the patient's chest or in the patient's abdomen.
For example, the reservoir may be located in the abdominal or thoracic cavity.
Alternatively, the lubricator or part thereof (eg, storage) may be planted by open surgery. There, for example, when the chest or abdominal wall is incised to place the lubricator in place within the patient's chest or abdomen, and then by what is preferably sutured in the layer and sutured. , Tissue skin and other layers close.
Preferably, it comprises the step of replenishing the reservoir and / or ejecting the amount of lubrication liquid by the injection port accumulated around the reservoir (eg, the reservoir).

Functional hip movements are to be understood as hip movements that correspond, at least in part, to the natural movements of the hips.
In some cases, the natural movement of the hip may be somewhat restricted or changed after hip surgery. And it creates a functional hip movement of the hip with an artificial surface that is somewhat different from the functional hip movement of the natural hip.

The functional position of an implantable medical hip device or prosthesis is the position in which the hip joint can perform functional hip movements.
The final position is to be understood as a functional position where the medical device does not require deeper position changes.

Functional knee movements are to be understood as knee movements that correspond, at least in part, to the natural movements of the knee.
In some cases, the natural movement of the knee joint may be somewhat restricted or changed after knee osteoarthritis surgery. It then creates a functional knee movement of the knee joint that has an artificial surface that is somewhat different from the functional knee movement of the natural knee joint.

The functional position of an implantable medical knee device or prosthesis is the position in which the knee joint is capable of performing functional knee movements.

A functional knee joint is a knee joint that is capable of performing functional knee movements with or without an implanted medical device or artificial organ.

When the medical device is inserted into the knee joint, the full functional size is to be understood as the dimensions of the medical knee device.

Arthroscopy is to be understood as a key hole surgery performed in a joint, since the arthroscopic procedure could be performed in the patient's abdomen, this arthroscopic procedure The inventions, where some of the steps are more laparoscopy and the two are referred to as arthroscopy and laparoscopy, are used synonymously for this, and the main one is among these methods. It is minimally invasive that they are for the intended invention.

A medical device according to any of the examples can consist of at least one who has selected from the group that the material consists of:
Polytetrafluoroethylene (PTFE) Perfluoroalkoxy (PFA) Fluorinated ethylene propylene (FEP).
It is further conceivable that the material consists of a metal alloy (eg cobalt-chromium-molybdenum or titanium or stainless steel), or polyethylene, eg crosslink polyethylene or gas, has sterilized polyethylene.
Among the ceramics used, the material may also be considered for artificial contact surfaces or for all medical devices (eg zirconium or zirconium dioxide ceramics or alumina ceramics).
The part of the medical device that contacts the human bone for fixation of the medical device to the human bone is a porous micro that is adapted to promote the growth-in of the human bone of the medical device for fixing the medical device. Or it can consist of a poor hospital structure that could be a nanostructure.
Porous structures are hydroxyapatite (HA) coated or coarsely open-por
It can be provided by applying an ed titanium coating (which can be done by air plasma spraying). And the combination consisting of the rough opened-pored the titanium coating, and the HA surface is also conceivable.
The contacts are waxy modified polymers (eg PTFE, PFA, FEP, PE or UHMWP).
It could have been made of a self-lubricated material such as E) or a powder metallurgy material that could be infused with lubricating oil. And it is preferably a biocompatible lubricant (eg, a Hyaluronic acid derivative).
It is also conceivable that in the specification of the present application, the material that contacts the part or surface of the medical device is adapted to be constantly or intermittently oiled.
According to some embodiments, parts or parts of the medical device are a combination of metal and / or carbon fiber and / or boron, a combination of metal and plastic material, a combination of metal and carbon-based materials, carbon. And can consist of plastic-based material combinations, flexible and hard material combinations, elastic and less elastic body combinations, Corian or acrylic polymers.

Note that any embodiment or part of an example can be combined in any way or in the same way as a part of a method.
All embodiments herein are generally combined in any form in general description.
Therefore, it must be seen as part of the candidate.
Note that the general description must be considered to describe both the device and the method.

If this type of combination is clearly incompatible, the various above-mentioned features of the examples may be combined in any way.
Examples are described in more detail with respect to the drawings currently attached.
Also, individual features of the various embodiments may be combined or exchanged, unless this type of combination or exchange is clearly compatible with the overall functioning of the device.

Shows the body of a patient with an implanted lubrication device for hip and / or knee joint lubrication. Illustrates a hip joint and a knee joint, each of which has an injection member of an implanted lubrication device fitted therein in FIG. Illustrates a hip joint and a knee joint, each of which has an injection member of an implanted lubrication device fitted therein in FIG. Indicates a lateral view of the knee joint where the medical device was provided. According to one embodiment, a medical device in cross section is shown. Illustrate the main components of a planted lubricator; A motor-driven planted lubricator that establishes a circular flow path is shown. An implanted lubrication device with an injection needle and drive mechanism is shown. The lubrication device of FIG. 2A which has substantially a slight modification is shown. A cross-sectional view of a compact embodiment of an implantable infusion device is shown. A suitable motor drive pump unit is shown for the relationship with the illustrated embodiment of Figure 1F. A medical device is shown according to an embodiment consisting of an artificial contact surface. A medical device, cross section, is shown according to an embodiment consisting of an artificial contact surface. A front view of a human patient showing the hip joint is shown. Indicates that when a laparoscopic / arthroscopic procedure is performed, the sides are seen in a human patient in cross section. Shows the hip joint in cross section with a hole in the pelvic bone. Shows the hip joint in cross section with a small hole in the pelvis. Shows the hip joint in cross section where the medical device was provided by a hole in the pelvis. Shows the hip joint in cross section where the medical device is provided by a hole in the pelvis. Shows the hip joint in cross section where the medical device was provided by a hole in the pelvis. When a medical device connected to an implantable lubricator is provided, the hip joint indicates a cross section. In the present specification, surgical instruments used in a method of providing a medical device according to any of the examples are shown. In the present specification, surgical instruments used in a method of providing a medical device according to any of the examples are shown. In the present specification, surgical instruments used in a method of providing a medical device according to any of the examples are shown. Shows the hip joint in cross section where the medical device was inserted and connected to the implantable reservoir. The side view of the hip joint ion part which a hole is made by the bone of a femur is shown. Shows the hip joint in cross section where the medical device is provided by the bone hole in the femur. Shows the hip joint in cross section where the medical device was provided by a hole in the bone of the femur. The storage that is adapted to be connected to the medical device in more detail is shown. The injection of the lubricating fluid into the implantable injection port is shown. The implantable medical device of the reverse embodiment is shown. The hip joint in cross section, the implantable medical device of the reverse embodiment, is shown to have been placed. The hip joint in cross section, the implantable medical device of the reverse embodiment, is shown to have been placed. The hip joint in cross section, the implantable medical device of the reverse embodiment, was placed and connected to the reservoir. The front view of the knee joint of a human patient is shown. A front view of the knee joint of a human patient, showing that a medical device was provided. An implantable lubrication system is shown. A side view of the knee joint where the medical device was located shows that it was given to the bone of the femur. A side view of the knee joint where the medical device was located shows that it was given to the tibial bone. Shown is a medical device consisting of an artificial knee osteoarthritis surface. Shown shows a medical device consisting of an artificial knee osteoarthritis in cross section. The medical device which consists of a plurality of medical device departments is shown. A medical device consisting of a plurality of medical device parts at the time of assembly is shown. Indicates that a medical device consisting of multiple medical device parts is placed when fixed to the tibial bone. An implantable medical device according to an embodiment is shown when fixed to the tibial bone and connected to the reservoir and infusion port. A front view of a human patient equipped with an implantable lubrication system is shown. An implantable lubricator is shown in more detail. In more detail, an implantable swivel lubricator is shown. In more detail, an implantable swivel lubricator consisting of a filter is shown. An implantable lubricator, indicating that the artificial hip joint surface is lubricated. A portable lubricator consisting of retractable needles, the first state. An implantable lubricator consisting of a retractable needle in the second state is shown. It is shown that a system for treating a disease, a system, includes a device of the present invention to be implanted in a patient. Various embodiments of the system for driving the device shown in FIG. 34 wirelessly are shown graphically. Various embodiments of the system for driving the device shown in FIG. 34 wirelessly are shown graphically. Various embodiments of the system for driving the device shown in FIG. 34 wirelessly are shown graphically. Various embodiments of the system for driving the device shown in FIG. 34 wirelessly are shown graphically. Various embodiments of the system for driving the device shown in FIG. 34 wirelessly are shown graphically. Various embodiments of the system for driving the device shown in FIG. 34 wirelessly are shown graphically. Various embodiments of the system for driving the device shown in FIG. 34 wirelessly are shown graphically. Various embodiments of the system for driving the device shown in FIG. 34 wirelessly are shown graphically. Various embodiments of the system for driving the device shown in FIG. 34 wirelessly are shown graphically. Various embodiments of the system for driving the device shown in FIG. 34 wirelessly are shown graphically. Various embodiments of the system for driving the device shown in FIG. 34 wirelessly are shown graphically. Various embodiments of the system for driving the device shown in FIG. 34 wirelessly are shown graphically. Various embodiments of the system for driving the device shown in FIG. 34 wirelessly are shown graphically. Various embodiments of the system for driving the device shown in FIG. 34 wirelessly are shown graphically. Various embodiments of the system for driving the device shown in FIG. 34 wirelessly are shown graphically. FIG. 34 is a schematic block diagram illustrating an apparatus for supplying an accurate amount of energy used for the operation of the apparatus shown in FIG. 34. Schematically, the embodiments of the system show that the device was actuated by the energy associated with the leads as to which one it was. FIG. 34 is a more detailed block diagram of a device for controlling the transmission of radio energy used for the operation of the device shown in FIG. 34. FIG. 52 is a circuit for an apparatus consistent with a possible embodiment. Pneumatic tires implanted in patients that can be driven within various methods or devices of arranging hydraulic application machines. Pneumatic tires implanted in patients that can be driven within various methods or devices of arranging hydraulic application machines. Pneumatic tires implanted in patients that can be driven within various methods or devices of arranging hydraulic application machines. Pneumatic tires implanted in patients that can be driven within various methods or devices of arranging hydraulic application machines. Pneumatic tires implanted in patients that can be driven within various methods or devices of arranging hydraulic application machines. Pneumatic tires implanted in patients that can be driven within various methods or devices of arranging hydraulic application machines. Pneumatic tires implanted in patients that can be driven within various methods or devices of arranging hydraulic application machines. Pneumatic tires implanted in patients that can be driven within various methods or devices of arranging hydraulic application machines. Pneumatic tires implanted in patients that can be driven within various methods or devices of arranging hydraulic application machines. Pneumatic tires implanted in patients that can be driven within various methods or devices of arranging hydraulic application machines. Pneumatic tires implanted in patients that can be driven within various methods or devices of arranging hydraulic application machines.

In the following, a detailed description of preferred embodiments will be given.
In the drawings, elements that are the same or correspond to the entire number of digits, such as reference numbers, are shown.
It goes without saying that these figures are for illustrative purposes only and do not limit the scope in any way.
Thus, any reference to a direction is only related to, for example, the direction shown in the figure "up" or "down".
Also, any dimensions etc. In the figure, the purpose is shown for illustration purposes.

Note that any embodiment or part of an example can be combined in any way or in the same way as a part of a method.
All embodiments herein are generally combined in any form in general description.
Therefore, it must be seen as part of the candidate.

FIG. 1 shows the body of a patient with an implanted lubrication device consisting of a main body 1401 and a two-fluid connecting tube 1402 that carries a lubricating fluid stored in a storage section at a joint for oiling. Here the hip joint and the knee joint.
To this end, the main body 1401 may consist of a reservoir for storing the lubricating fluid and may also consist of deeper components (eg, pumps, motors, controls, etc.).
The lubricator (ie, all its components) is fully implantable to the patient's body so that the joint can be properly lubricated after surgery to any extracorporeal component or each in the infusion. And it significantly reduces the risk of infection for the patient.
Depending on the type of joint and on the severity of damage to the joint, the joint may be lubricated intermittently / periodically, continuously or as needed. And it depends on, for example, the lubricating fluid surface in the contacts.
Usually, the main body 1401 of the lubricator is subcutaneously accessible, for example during replenishment of the reservoir or to prepare a function or mode of operation via a wireless control device or the like. May be planted in.

In FIGS. 1A and 1B, the two oiled joints shown in FIG. 1 (hip and knee joints) are illustrated in more detail, respectively.
It can be seen in FIGS. 1A and 1B that the fluid connection tube 1402 has an injection member fitted at its end into a common space that finally brings the lubricating fluid to the joint. The figure shows 1A, an injection needle 1403 ejected in a communal capsule into the communal space of the hip joint.
The injection needle 1403 may advance into a communal space in connection with a drive mechanism (not shown) and may then be retracted to intermittently lubricate the joint.
Alternatively, in FIG. 1B, the injection member is an injection tube 1404 that is permanently placed in a common space so that a continuous flow of lubricating fluid reaches the contacts.
The material of the injection tube 1404 may be a soft material or, at a minimum, only interfere with its regular movement joints.
The drive mechanism is not required for the injection tube 1404 of FIG. 1B.

There are usually two basic methods of inserting a lubricator (the conventional method in which the area of the joint is freely incised and the injection needle 1403 or injection tube 1404 is placed in the freely incised area). And the laparoscopic method with joint voids was laparoscopically inflated,
Then, the injection needle 1403 or the injection tube 1404 is placed in the cavity by the laparoscopic trocar.
When the fluid connection tube attaches a tube to the end of 1402 of the injection needle 1403, as shown in FIG. 1A,
The needle drive mechanism may introduce the injection needle 1403 intermittently with the communal space and may store it so that the lubricating fluid stored in the reservoir is injected intermittently. In such a manner, the injection needle 1403 is placed in a co-capsule or in close contact with the hole in the capsule.
Alternatively, if the fluid connection tube attaches a tube to the end of 1402 of the injection tube 1404, as shown in FIG. 1B, the permanent hole is such that the lubricating fluid may be continuously injected into the joint. Made in a joint capsule that is placed continuously.

FIG. 1C shows a medical device according to an embodiment consisting of a first artificial contact surface 1101 adapted to replace the distal surface of the femoral bone 102 (which is the elbow joint).
The first artificial contact surface 1101 can be adapted to replace the surface layer of the lateral articular hill, medial articular hill or laterally medial articular hill.
In the figure, medical device 1C is another contact surface of the knee joint further consisting of a second artificial contact surface 1102 adapted to replace the contact surface of the tibial bone.
The implantable medical device adapts to receive the lubricating fluid from the reservoir 1108 Inlet 1104
Consists of. And it according to this example is placed on the posterior aspect of the tibial bone 102 and the posterior aspect of the femur bone 102, respectively.
Reservoir 1108 is an injection port 1107 located in fluid contact with the reservoir 1108.
Consistent with this example adapted to be replenished by.
Reservoir 1108 supplies inlet 1104; 1123 having a lubricating fluid by conduit 1106 that supplies the fluid connection tube between the medical device and reservoir 1108.
The reservoir is adapted to be placed under pressure by the injection port 1108, which consists of a chamber for further compressed pressurized gas when the reservoir 1108 is filled by the injection port 1107. Matches the example.
Inlet 1104; 1123 transports the lubricating fluid to channels 1105, which are at least partially integrated on the artificial contact surfaces 1101, 1102.
According to the embodiment of FIG. 1, channel 1105 is fully integrated in the medical device.
Channel 1105 improves its function by spraying the lubricating fluid onto the artificial contact surface 1101, and thereby oiling the artificial contact surfaces 1101, 1102 and reducing friction.
Implantable medical devices can be adapted just as well because they are implanted in the knee joints of other mammals (eg horses).

FIG. 1D shows a implantable medical device according to an embodiment in which the medical device is adapted to replace the hip joint.
The medical device is provided with multiple channels 1105 adapted to lubricate the artificial contact surface of the hip joint with the infused lubricating fluid, such as a channel by a centrally located conduit in the implantable medical device. It is configured in.
Conduit 1106 arranges a plurality of channels 1105 of fluid connection with a reservoir 1108 located at the stalk (in the medical device, adapted for bone fixation of the femur of a human patient).
The conduit 1106 carries the lubricating fluid through channel 1105 to inlet 1123 for deeper distribution.
The storage section 1108 according to the embodiment of FIG. 1D is a spring mounted by a spring 1109 that pushes a movable wall portion in the shape of a piston 1110 for arranging the lubricating fluid under pressure.
Reservoir 1108 is adapted to be replenished by injection port 1107. It is then placed on the lateral side of the medical device.
Injecting the lubricating fluid through the injection port 1107 compresses the spring 1109 which places the lubricating fluid under pressure. And for that, the pressure lubricates the hip joint of the human patient and squeezes the lubricating fluid through the conduit 1106 and against the channel 1105.
The loaded reservoir 1108 comprises a chamber filled with a lubricating fluid (eg, a pressurized gas further pressurized by injecting a lubricating fluid through an injection port).
Spring, storage 11 which can be replaced with other types of storage adapted to be placed in
It is further conceivable that the case where 08 stores the elastic properties of rubber in the reservoir is the elastic reservoir pressurized to the lubricating fluid.

The figure illustrates 1E, the planted lubricator and its main components.
The lubrication device in the figure is a fluid connection tube 140 connecting 1E, a reservoir R for storing the lubricating fluid and an injection tube 1404 that is permanently arranged by its open end in a common space with the reservoir R.
It consists of two.
Lubricating fluid and injection tube 1 from reservoir R by fluid connection tube 1402
To create the appropriate pressure to press the 404 into the joint, the gas chamber 1407 is placed within a reservoir R that may generate the required pressure as soon as its volume is expanded.
In addition, the replenishment injection port 140 arranged on the outer wall of the reservoir R so that the lubricating fluid can be replenished to the reservoir R by a syringe ejected by the patient's skin 1405.
The reservoir is inserted subcutaneously so that 6 is more accessible to the patient's skin 1405.
The replenishment injection port 1406 may thus be made in a suitable membrane (eg, a polymeric material). And it is self-sealing with respect to the penetration of the infusion syringe.

FIG. 1F shows another embodiment of the lubrication device according to the present invention.
The pump P driven by the motor M is from the reservoir R and the two pipes 1402a (1402b forming a perfect circular flow path for the lubricating fluid through the reservoir R and the oiled joint). A circular fluid connection pipe 1402 is connected.
Of the two pipes 1402a each, 1402b consists of individual injection pipes 1404a (1404b fitted into a common space), while the lubricating fluid stored in the reservoir is via the pipe 1402a having the injection pipe 1404a. Introduced in a common space. On the other hand, the lubricating fluid used is stored via the tube portion 1402b with the injection tube 1404b via the filter element 1427 with the filter 1428 which is partially located in the flow path defined by the tube section 1402b. Guided from the joint to the part.
Under the pressure created by the pump P, the lubricating fluid is fluid connection pipe 1402a (1402).
It circulates continuously in the circular flow path formed by b). The lubricating fluid may then be at least partially reused after passing the joint.
However, foreign added to the lubricating fluid on their way by the joints from the contacts and to allow re-usage or something of the lubricating fluid flowing into the injection tube 1404b, possible dirt and impurities. Particles are removed by the filter device 1427 to fix the quality of the lubricating fluid and the desired effect on the re-usage.
The filter device 1427 comprises a filter device 1428 that is placed in the flow path so that the complete lubricating fluid passes through the filter.
The filter device 1427 is adapted to periodically clean the filter 1428 by removing the filtered particles from the filter 1428 and placing them in a sealed sedimentary space 1433.
Alternatively, the removed particles, for example in blood vessels, can be returned to the patient's body.

Specific storage types will be described later, even though the illustrated examples in the figure may consist of a wide variety of storage types on the 1st floor.
On the 1st floor, the amount of storage portion R shown in the figure is divided into two portions by the membrane 1429.
Some parts are filled with gas, while others are filled with lubricating fluid.
Replenishment infusion port 1430 takes into account replenishment of reservoir R with infusion liquid by a replenishing needle by the patient's skin 1405.
When the reservoir R is in its perfect state, the gas section is at ambient pressure or ove
It was r-pressurized.
As the lubricating fluid is poured from the reservoir R into each lubrication cycle, the pressure in the gas section decreases under ambient pressure, i.e. to a negative relative value.
To prevent pump P from any backflow to the reservoir R and other operating ball valves 1432 to prevent any backflow into the fluid connection conduit 1402b, depending on the particular type of pump P. It may be advantageous to provide a ball valve 1431 in operation.

Exercise M is wirelessly controlled by control device C, which is also implanted in the patient's body.
However, placing the control device C outside the patient's is the control device C and the motion M.
It is also possible to embody wireless communication with and to establish or provide electrical contact by the patient's skin.
Preferably, the control device C is planted in addition to the motion M. In that case, the controller C is preferably programmable from outside the patient's body, either wirelessly or by electrical contact, in order to allow proper configuration of the controller according to varying requirements.
The controller C determines the time between each injection cycle as well as the amount of lubricating fluid injected into the space.
In addition to or instead of control device C, a pressure sensitive switch for invoking exercise M may be placed subcutaneously.

There are various ways to provide energy to Exercise M.
For example, energy may be entrusted to accumulator A (eg, a rechargeable battery and / or capacitor) to supply the patient's body, eg, from the outside.
In the illustrated embodiment of FIG. 1F, the main extracorporeal energy source E is the energy that converts the energy of the first form by the patient's skin 1405 into the energy of the second form (for example, electric energy). Send to the conversion device T.
The electric energy is used to recharge the accumulator A, which supplies the motion M with a second energy for demand.

In general, an external energy source E may be adapted to create an external field (eg, an electromagnetic field, magnetic field or electric field) or generate a wave signal (eg, an electromagnetic or sonic signal).
For example, the energy converter T shown in the figure may act as a 1F solar cell, but is altering the device T of the main energy source. Energy may also adapt to certain types of wave signals that may adapt to turn temperature changes into electric energy.
Instead of the external primary energy source E, a portable primary energy source E, such as a regular long-life battery, may be used instead of the accumulator A. Regardless of whether the energy is conducted wirelessly or by a wire, thus serving as a carrier signal for digital or an analog control signal, the energy signal is provided by control device C by appropriate modulation of the energy signal. It can also be used to transmit control signals.
More specifically, the control signal may be a frequency, phase and / or amplitude modulated signal.

The figure shows in more detail an implanted lubricator consisting of an injection needle 1403 with a tip end 1408, 2A.
The tip end 1402 is closed at its end and has a lateral lubricating fluid transfer exit port 1409.
The needle 1403 is arranged for vertical replacement within the range of the fluid connection tube 1402 which is not restricted by the drive mechanism D depending on the activation.

The fluid connection pipe 1402 is a planted pump P.I. It can be attached to a pump and designed in a variety of ways.
In FIG. 2A, the lubricating fluid in which the reservoir R is injected into the patented common space or the pump P.I. The storage section R could be separate from the pump P and was connected to it, for example as shown in FIG. 2B as the main section.
In Figure 2A, however, Pump P (may be understood as a piston, etc.)
The movable or flexible wall 1410 is electrically replaceable to pump the lubricating fluid intermittently towards the injection needle 1403 from the reservoir R by the fluid connection tube 1402 (
Or manually).
Pump P could be driven by a motor, for example, and the motor is automatically controlled to inject a constant amount of lubricating fluid intermittently at specific time intervals via the injection needle 1403 into the communal space. be able to.
A reservoir R (pump P and / or other component of the implanted lubricator), such as the motors, automatic controls for motors, etc. described above, is preferably in addition to the injection needle 1403 and drive mechanism D. It will be planted. Needless to say, other suitable modifications are possible, as will be apparent, depending on the deeper consideration of the other embodiments of the invention.

2A, in the lubrication device shown in Fig, as the pressure increases in the reservoir R due to the activation of the movable / flexible wall 1410, this thus drives the drive mechanism D.I.
Spring 1 (1408 tip end of injection needle through which 1403 penetrates into the oiled communal space)
The result is a replacement of the injection needle 3 with respect to the force of 411.
The ball valve 1412 has a second return spring that is stronger than the first return spring 1411 when the return spring 1411 is fully compressed and the moving / flexible wall 1410 further increases the pressure acting on the lubricating fluid. The position shifts with respect to 1413.
As such, as long as the pressure is maintained at a sufficiently high level, the lubricating fluid is pumped into the common space of the patient from the reservoir R by the fluid connection tube 1402, the hollow injection needle 1403 and the needle exit port 1409.
The pressure is released immediately, the ball valve 1412 closes due to the return springs 1411 and 1413, and the injection needle 1403 is stored at 2A, in its initial position as shown.
This process is repeated cyclically, depending on the condition and the type of joint being lubricated, so that intermittent lubrication of a particular joint can be achieved.

It should be noted that the force acting on the injection needle 1403 to advance the same may be calculated as the product of the actual pressure and the intersection of the needle 1403.
Due to the relatively small cross-section of a typical injection needle, the high pressure must operate in a sequence that penetrates the common space and must overcome the opposite forces of the return springs 1411 and 1413. ..
As two tightly separated chambers are formed before and after the drive mechanism,
It is therefore advantageous for creating the drive mechanism D.
Thus, when the chamber behind the drive mechanism D is kept at low pressure (eg ambient pressure), the force acting on the injection needle 1403 is the product of the actual pressure and all cross sections of the drive mechanism D. Correspondingly, thus, it is substantially higher.

This is shown in FIG. 2B.
The drive mechanism D is provided with a piston 1414 and is configured to which injection needle 1403 is attached as shown in FIG.
The piston 1414 has the piston 1414 and the second chamber 1415 after the piston 1414.
The first chamber 1415a is disconnected in front of b.
The pressure in the first chamber 1415a corresponds to the pressure operated by the pump P and the second
The pressure in the chamber 1415b can be kept low.
For example, chamber 1415b can be filled with compressible gas.
In that case, the return spring 1411 can be omitted as the compressed air already creates the needle contraction force.

Safely, however, closing the gas chamber is difficult.
Therefore, the second chamber 1415b is instead filled with a fluid (eg, a lubricating fluid), and the liquid may be pressed into a flexible volume 1416.
The flexible volume 1416 could have been in a simple balloon type to fill on without any strong preemptive nuclear attack weapons.
Alternatively, the flexible volume 1416 may consist of a gas chamber separated from the fluid in the second chamber 1415b by a flexible membrane.
Further, the return spring 1411 can be omitted in this case.

Instead of flexible volume 1416, conduit 1417 (acts as fluid connection tube 1402)
May connect the second chamber 1415b to the reservoir R.
Thus, as the injection needle 1403 advances, the fluid is ejected into the reservoir R from the second chamber 1415b by the conduit 1417, and as the injection needle 1403 is stowed by the return spring 1411, the fluid becomes second. It is returned into the chamber 1415b of 2 and poured from the storage section R by the conduit 1417.
The pump, to which P and reservoir R is, is a remote unit, or optionally, a single unit that is inserted into the patient's body in addition to the drive mechanism D and needle 1403.

FIG. 2C shows that a very compact lubricator is inserted subcutaneously, and in close proximity and in a suitable relative position to the lubricated joint. Then, the needle 1403 may intermittently advance to the joint in response to activation by the drive mechanism D.
The individual components of the device are a single structure 14 consisting of 1419a, 1419b and an outer wall.
It is included within the range of 18.
The volume is defined by the outer wall 1419a, which is completely filled with lubricating fluid.
The wall portion 1419a is flexible to take into account the volume changes occurring at each injection and replenishment.
The wall portion 1419a is made of a polymeric material that is self-sealing with respect to the penetration of the injection needle 1403.
Along with being implanted subcutaneously, the lubricator can thus be replenished with the lubricating fluid by the polymer wall portion 1419a.

The other wall portion 1419b is rigid to provide some stability to the individual components contained within the body 1418.
The window region 1420 is formed on a rigid wall portion 1419b and a osmosis membrane in which 1421 is press-fitted and sealed in the window region 1420.
The osmosis membrane 1421 is made from a self-sealing material with respect to the penetration occurring from the injection needle 1403. And for that purpose, the injection needle is placed through the window area 1420, thereby penetrating the space where the joint is oiled.

As mentioned above with respect to FIG. 2B, the needle 1403 is connected to the piston 1414, which separates the first chamber 1415a after the piston 1414 and in front of the piston 1414 and the second chamber 1415b.
A ball valve 1412 having a return spring 1411 and a return spring 1413 is also provided.
The opening 1422 holds the second chamber 1415b so that the pressure rises in the first chamber where the pressure 1415a piston 1414 may oil and discharge the fluid from the second chamber 1415b through opening 1422 into the storage R. Provided to connect to R, R is almost any reservoir at ambient pressure.

The pressure in the first chamber 1415a is increased by a pump P consisting of a movable / flexible wall 1410 that is moved back and forth by a suitable drive mechanism, motor or the like.
The flow passage 1423 is formed in a housing 1424 in which the piston 1410 is slidably arranged.
The flow passage has a flow compression 1425 and an outlet opening 1426 in the housing 1424.

The infusion device shown in the figure in which 2C works continues.
Due to the flow contraction 1425 of the flow passage 1423, the lubricating fluid contained in the first chamber 1415a is stored by the flow passage 1423 when the movable / flexible wall 1410 is acted upon (ie, moving in the direction of the arrow). However, the lubricating fluid is ejected from the second chamber 1415b through opening 1422 into the storage portion R, and the piston 1412 having the needle 1403 is pressed against the window region 1420.
The piston 1412 is in its terminal position, and the movable / flexible wall 1
As the 410 moves further in the direction of the arrow, the pressure in the first chamber 1415a eventually becomes
Rise to a level high enough to overcome the spring force of the return spring 1413,
This opens the ball valve 1412 and the lubricating fluid released by the hollow needle 1403,
Allow a joint in which the tip end where 1408 pierces the membrane 1418 and the body 1418 of the lubricator is properly placed.
Immediately release 1415a by moving backward in the first chamber, which is movable / flexible in the pressure of the first chamber, 1412 closes immediately Piston 1412 with a ball valve and injection needle 1403 is simultaneously in its retracted position. To be pulled back.
Even after the piston 1412 has reached its initial position, the circulation passage 1423 is necessary for the movable / flexible wall 1410 to be able to move further backwards. Thereby, additional lubricating fluid is drawn from the reservoir R into the first chamber 1415a (where the amount of lubricating liquid is circulated by the additional lubricating fluid co-pendates discharged to the patient during intermittent injection).
In addition to the intermittently advanced and retracted drive mechanism D capability, 2C, the drive mechanism of the lubricator shown in the figure, is a tip in which 1408 of the lateral injection sews 1403 to prevent fibrosis etc. It may further consist of means for moving the ends.

2C, the lubrication device shown in the figure does not include any gas chambers and is any mobile /
It provides some effects such as the need to specifically seal the flexible wall 1410 and piston element 1412.
It should be noted that all components of the infusion device shown in FIG. 2B may be made from a polymeric material. However, at least the injection needle 1403 and the return spring 141
It is preferred that 1 1413 is made from an inert metal.

FIG. 2D shows a cross-sectional view of a motor / pump unit that can be used in connection with the device shown on the 1st floor.
This motor pump unit is extensively described in WO 2004/012806 A1, and other pump units disclosed therein may be used in connection with the present invention as well.
Moon-Iwayama-Pump unit, 1434 is the main element of the assembly is the cylindrical housing 143
The two appointed valve pump assemblies attached to 5, in which the membrane pump P and the valve pump device are provided.
The valve device 1434 has a first valve member in the form of a ceramic disc attached to the housing 1435 and a ceramic disc 1436 and a rotatable relative that has been raised forward to a stationary disc 1436 with the immovable ones of 1436 raised. Includes a second valve member in the form of a ceramic disc 1437 that is in contact.
The motor 1438 is mounted in a housing 1435 that surrounds the ceramic discs 1436 and 1437.
The motor 1438 includes a splined motor shaft that connects to the corresponding spline in the central hole under the rotatable disc 1437 so that the disc 1437 can move somewhat axially in relation to the motor shaft 1439. .. However, the disc 1437 follows the rotation of the motor 1435.
On the motor shaft 1439, a spring washer 1441 that exerts a small amount of pressure on the disc 1437 to press against the stop member 1440 and the stationary disc 1436 is placed.

Pump P includes pump membrane 1451 which can be any kind of membrane.
Preferably, the membrane 1451 is a metal membrane (eg, a titanium membrane or a type of coated plastic material for achieving long life and avoiding the diffusion of liquids by the membrane 1451 over time).
The operating device (incorporated into the valve pump assembly in this embodiment) includes a cam sleeve 1452 having two cut grooves on opposite sides of the cam surface 1453. And cam wheel 145
4 (rotates in the cut groove pushing the cam surface 1453) and pump shaft 14
55 is connected to the rotating disc 1437.
The cam wheel 1454 is mounted on the pump shaft 1455 via a cam wheel set 1456.
The pump shaft 1455 rotates because it is connected to the rotating disk 1437 via a splined shaft 1461 that connects to the corresponding spline in the central hole 1461 above the rotatable disk 1437.
The spline fittings described allow the disc 1437 to move somewhat axially in relation to the pump shaft 1455.
The pump shaft 1455 is an encapsulated ball bearing 1458.
Mounted on the ball bearing 1458 and stationary in the axial direction.
Some elongated grooves 1459 on the pump shaft 1455 are past ball bearings 1
The 458 is extended and used as a liquid flow passage between the first channel 1442 of the static disk 1436 and the pump chamber 1460 under the membrane 1451.

As the motor 1438 rotates, the membrane 1451 moves up and down.
As the membrane 1451 moves up and down, liquid may also be transmitted from the second channel 1444 or the third channel 1445 to the pump chamber 1460, or the pump chamber 1456 beside the second channel 1444 or the third channel 1445. As also received from, the rotatable disc1437 takes turns on the first channel 1442 in the second 3
Connect to the main channels 1444 and 1445.
In FIG. 2D, the first channel 1442 goes through the open channel 1450 so that the second channel 1444 receives the liquid from the chamber 1460 by the first channel 1442.
Shown as connected to the channel of.

The particular material selected for discs 1436 and 1437 must be able to function with very fine tolerances without this kind of disc sticking to each other over time. The material is important.
There are several commercially available materials (e) that are suitable for this purpose. g. Ceramic or ceramic was mixed with other materials (eg carbon fiber).

FIG. 3 shows a medical device according to an embodiment in which the medical device is adapted to replace the head femoral contact surface of the femoral bone of a human patient.
The medical device that matches the artificial contact surface 1103b of the medical device in this embodiment is provided with a plurality of channels adapted to lubricate the hip joint of a human patient with a lubricating fluid.
The deeper medical device is provided with a fixing portion 44 for fixing the medical device and is configured like a colonic chimney femur of the femur and / or femur bone.

FIG. 4 shows a medical device consisting of multiple channels of fluid connection with a centrally located reservoir at a portion 44 fixed by conduit 1106 (not shown), FIG. 4 according to FIG. 3 in cross section. Channel 1105, which is fully integrated in a medical device indicating a medical device.
The conduit 1106 carries the lubricating fluid through channel 1105 to inlet 1123 for deeper distribution.
The conduit is a connection 1111 adapted to connect the first conduit to the second conduit 1106 or reservoir.
Ends in a node or additional channel.

FIG. 5 shows a front view of the body of a human patient. A laparoscope that operates the hip joint from the opposite side of the acetabulum 8 to provide a medical device according to any of the embodiments herein.
The arthroscopic method is illustrated.
The hip joint comprises an acetabulum 8 and a head femur 5.
A small incision made by 14 of the abdominal wall of a human patient into the patient's body for insertion of laparoscopic / arthroscopic trocars 33a, b, c.
Then to introduce, place, connect, attach, build, or fill one or more cameras 34, surgical instruments or implantable medical devices adapted to make holes in the pelvis 35. Instrument 36 can be fitted into the body of the laparoscope / arthroscope with trocars 33a, b, c.

FIG. 6 shows that side views of the human patient's body are shown and coalesced in cross section by the hips.
The hip joint is provided with a head femur 5 located on the very surface of the colonic chimney femur 6, which is the uppermost part of the femur bone 7.
The head femur 5 is associated with the acetabulum 8, which is the bowl-shaped portion of the pelvis 9.
Laparoscopic / arthroscopic trocars 33a, b, c are hip joints 3 having one or more cameras 34.
9. Instruments for introducing, arranging, connecting, attaching, making, or filling surgical instruments 35 or implantable medical devices adapted to make holes in the pelvis 9 3
Used to reach 6.

After the pelvis 9 is incised, FIG. 7 shows the creation of a hole 18 in the pelvis 9.
The hole 18 is made from the abdominal side of the pelvis 9 by repeating or continuous movement of the device 22 making a hole to be inserted into a human patient from the abdominal side of the pelvis 9.
The hole 18 passes through the pelvis 9 from the opposite side of the acetabulum 8 and into the hip joint 19.
According to the first embodiment in which the hole 18 is likely to be large, by which can the implantable medical device pass through the hole 18 of its full functional size.

FIG. 8a is much more as shown in FIG. 8a, which allows the device 22 in which the hole 20 made by the surgical or laparoscopic / arthroscopic method is made a smaller hole 20. A small second embodiment is shown, and thus also the incision and incision were performed in the human body.

FIG. 8b shows the hip joint in cross section when the medical device is installed between the femur 5 and the acetabulum.
The medical device according to this embodiment is provided with a plurality of channels 1105 connected to conduits 1106 connected one after another, and is configured as a mounting portion to be placed in a hole in the pelvis 9.
The conduit 1106 carries the lubricating fluid through channel 1105 to inlet 1123 for deeper distribution.
Due to the insertion of the pelvis 9 through the hole 18 smaller than the medical device, the medical device can be moved or compressed over the rollers, or according to other embodiments, in place, on the human body. It could be reabsorbed by, melted, or cast in any mold adapted to serve as a surface layer of a medical device.
Medical devices can be adapted for fixation using adhesives or mechanical fixing elements.

FIG. 9a shows the hip joint in cross section when a medical device is provided with a hole 18 in the pelvis 9 for replacing the contact surface of the head femur 5.
The medical device is configured like a head femur 5 with 44 centrally located in the medical device and provided with an artificial contact surface 1103b adapted to fix the medical device and a fixing portion. There is.
The medical device is provided with a plurality of channels 1105 that are exposed to an artificial contact surface for oiling the hip joint.
The channels are, in turn, in a fluid connection having a conduit 1106 connecting to an interconnected first 1111b that adapts to connect the conduit to a second conduit 1106b or a second portion of the conduit 1106b. And it is, in turn, in a fluid connection having a reservoir 1108 placed in the bone 7 of the femur of a human patient.
Reservoir 1108 is placed in femoral bone 7 and adapted to retain pressurized lubricating fluid. Then, according to the illustrated embodiment of FIG. 9a, it is pressurized by the storage portion 1108 mounted by the spring 1109 in connection with the movable wall portion in the form of a piston 1110 pressurizing the lubricating fluid that it is spring.
The reservoir 1108, however, is further connected to an injection port 1107, which is located under the greater trochanter 1186 in association with the femoral bone 7. And in relation to the bone, any other suitable placement may be possible, either in the void or subcutaneously.
The medical device is consistent with the embodiment in the figure 9a operable with a pressurized reservoir, however, according to other embodiments, the medical device is operated by a driven, operating device (eg, an implantable pump). It is possible. It can then be driven by direct propulsion (eg, inductive or magnetic propulsion) or by a stored energy source (eg, battery).
A channel or conduit (not shown) can be so according to an embodiment in which the conduit 1106 or channel 1105 closes the flow of lubricating fluid and consists of a valve. Thereby, the bond with the storage part and the artificial contact surface is completed.
The valve can be driven and adapted, for example because it is a remote controlled form of the outside of the human body.

FIG. 9b shows the hip joint in cross section when the medical device according to another embodiment is provided to the hip joint. It then replaces the contact surface of the head and femur.
The medical device is provided with an artificial contact surface 1103b in which a plurality of channels 1105 connected to the conduit 1106 are arranged to be fixed and separated in the medical device.
The conduits are, in turn, in fluid connections with a reservoir 1108 located within the bone of the femur, preferably in the cancellous portion of the bone of the femur. And the reservoir is thereby in a fluid connection having a channel of the medical device for oiling the artificial contact surface 1103b of the medical device.

FIG. 10 shows the hip joint in cross section when an adaptive implantable medical device is provided to replace the acetabular contact surface.
The medical device is provided with an artificial acetabular surface 65 composed of a plurality of connected channels and is configured as a conduit 1106 by interconnected 1111 parts.
The medical device is consistent with the illustrated embodiment of FIG. 10 adapted to be placed in the hole 18 of the pelvis 9 to replace the acetabular contact surface 65.
FIG. 10 further reveals to the device to which the conduit 1106 is connected, according to one embodiment, the device consists of 1113a, a reservoir 1108 and two devices creating pressure. The 1113b is then adapted to create pressure by the conduit 1106 and further by the plurality of channels 1105 to lubricate the implantable medical device to pressurize the lubricating fluid for squeezing the lubricating fluid.
The conduit 1106 carries the lubricating fluid through channel 1105 to inlet 1123 for deeper distribution.
The device creating the pressure could be a loaded spring, or consists of a pressurized gas-filled element that is further pressurized by injecting a lubricating fluid into the reservoir 1108.
The device further comprises an injection port 1107 consisting of a self-sealing membrane 1112. And it is preferably a parylene coated silicone film.
Matching the device to other embodiments comprises a pump-like driven operating device housed in a container 1113a that pumps lubricating fluid from storage 1108 through conduits 1106 to a plurality of channels 1105.
According to one embodiment, the pump is driven by a battery housed in compartment 1113b.

According to a first embodiment, FIG. 11a shows a surgical instrument adapted to fit a medical device according to any of the examples in the present specification or a mold for making a medical device.
The surgical instrument includes a gripping portion 76 and a handling portion 77.
According to the illustrated examples of FIGS. 11a, 11a, b, c, the instrument further comprises a rotating member 78 that allows the gripping part 76 to rotate with respect to the handling part 77, however, the surgical instrument is this. The lack of a rotating member 78 is equally considered.

FIG. 11b shows a surgical instrument adapted to fit an artificial organ, prosthesis or portion necessary to create or provide a hip joint surface according to a second embodiment.
According to this embodiment, the surgical instrument further consists of Section 79, which is displaced in parallel. It then increases the area of the instrument and facilitates reaching the hip joint through the pelvic hole from the contralateral side from the acetabulum.

FIG. 11c shows a surgical instrument adapted to fit an artificial organ, prosthesis or portion necessary to create or provide a hip joint surface according to a third embodiment.
Two angles adjusting the members 80a, b are provided to match the deeper surgical instruments in this embodiment.
The angle-adjusting member could be adjustable to change the angle of the grip 76 with respect to the handling portion 77, or act on the hip joint through a pelvic hole from the opposite side of the acetabulum 8. Fixed at an angle suitable for making.

FIG. 12 shows the hip joint in cross section when the medical device is provided.
The implantable medical device is adapted to replace the acetabular surface, however, a possible medical device fitted in the hole 18 of the pelvis 9 of another embodiment in which it is equally likely is the 7 of the femur. Adapted to be inserted in the hole of a book bone or hip capsule.
The medical device is provided with a plurality of channels 1105 interconnected by conduits 1106 for arranging fluid connection channels 1105 having each.
The conduit 1106 carries the lubricating fluid through channel 1105 to inlet 1123 for deeper distribution.
The conduit 1106 is further connected to the first part of the inter-connection part 1111 which is adapted because it is connected to the second part of the part 1111b at the time of tell connection.
The interconnected first part connects the first part of the conduit 1106 to the second part of the conduit 1106. The first portion of the conduit 1106 can then be fitted from the acetabular side of the pelvis 9 and the side of the pelvis of the pelvis 9 or from the second portion of the conduit 1106 that is fitted from the opposite acetabular side. To do.
The connection of the two parts of the conduit 1106 is particularly beneficial when the medical device is fitted by the bone 7 of the femur or the hole 18 of the hip capsule, and the reservoir 1108 is of a human patient or of the pelvis 9. It is inserted into the abdomen of another area on the abdominal side.
The conduit 1106 then further connects to the reservoir 1108 and is adapted to carry the lubricating fluid from the reservoir 1108 to the area of the hip joint.
The reservoir 1108 is for arranging the lubricating fluid under pressure by the conduit 1106 and further by the spring 1109 which is waving a force on the movable wall portion in the form of a piston 1110 squeezing the lubricating fluid by the channel 1105. Consistent with the illustrated embodiment of FIG.
The deeper reservoir 1108 is provided with an injection port 1107 that is placed at the top of the reservoir 1108 to replenish the reservoir 1108 and at the same event that is increasing the pressure of the lubricating fluid.

FIG. 13a shows a side view of a human patient showing a hip joint in cross section.
The femur bone 7 is the proximal femur consisting of the colonic chimney femur 6 and the head femur 5 closest to most.
In FIG. 13a, the hole 82 is made from an incision made in the colonic chimney femur, followed by the head femur 5, and thus in the hip joint and in the thigh (the hole transfer of the femur to the femur 7). Has been done.
The hole is used to provide a medical device that is preferably possible to roll into the hip joint or bend for insertion through the hole 82.

FIG. 13b shows the hip joint in cross section when the medical device is provided by the hole 82 in the bone 7 of the femur and fixed in the acetabular bowl 8.
The medical device is provided with a plurality of connected channels 1105, each configured by a conduit 1106.
According to other embodiments, the medical device can be provided by a hip capsule or a hole in the pelvis 9.
After the medical device is provided, the tool 1180 accommodating the reservoir 1108 connected to the conduit 1106'provides the reservoir 1108 to the hole 82 of the femur bone 7 to provide the reservoir as the medical device. Used to connect to conduit 1106.

FIG. 13c shows the bone hole 8 of the femur where the reservoirs 1108, 7 showing the hip joint in cross section were.
Connect to the medical device arranged in 2.
In addition, a conduit of 1106 feet reaching from storage 1108 to injection port 1107 for refilling and / or pressurizing storage 1108.

FIG. 13d reveals in more detail to the reservoir device, which consists of an intermounting portion 1111 located at the end of the reservoir device (pressurized reservoir 1108). Then, according to the embodiment of the figure, it is pressurized by a spring 1109 pushing the movable wall portion 1110 in the form of a piston 1110 at 13d.
The reservoir device is associated with the reservoir and, in connection with the injection port 1107, to fill the reservoir 110 further consisting of 1106 feet of conduit and / or consisting of a lubricating fluid.
Pressurize to 8.
1107 completions per self, sealing the membrane (which could be the self sealing the silicone membrane of parylene coat) to inhibit cell migration on the surface of the injection port, injection port.
Sections AA are the reservoir 1108 for filling and / or pressurizing the reservoir 1108.
In the center of, the centrally located conduit 1106 is shown.

FIG. 14 shows a side view of a human patient in cross section. The lubricating fluid is then injected into the injection port 1107 by an ejecting member 92 made of a container 1115 adapted to contain the injected lubricating fluid.
The infusion port connects to a implantable medical device placed in the hip joint by a conduit 1106 adapted to supply a fluid connection tube between the infusion port and the medical device.
The medical device, in turn, consists of a plurality of channels 1105 for lubricating the artificial contact surface, thereby lubricating the hip joint.
According to the illustrated embodiment of FIG. 14, the medical device is then replenished with a removed bone plug, fed from the abdominal side of the pelvis 9 by a hole made in the sealed pelvis, and screwed in. It was fixed by the fixed part of the machine.
According to another embodiment, the medical device is a pelvis 9 with a hip capsule 12 or a femoral bone 7.
Pelvis 9 by part 1111 which is provided from the hip joint side of the
It connects to the conduit 1106 on the abdominal side of the.
This allowed the injection port 1107 of the abdominal cavity to be placed subcutaneously and / or supported the tissue with a muscular or fascial.

FIG. 15 shows a medical device of the reverse embodiment in which the medical device consists of a first artificial contact surface 112 having a convex shape towards the center of the hip joint.
The first artificial contact surface 112 is adapted for fixation to the pelvis 9 of a human patient.
The artificial convex hip joint surface 112 is adapted for fixation to the pelvis 9 and for insertion through the hole 18 in the pelvis 9.
The medical device consists of a nut 120. Then, it is composed of a thread for safely fixing the medical device to the pelvis 9.
Deeper medical devices are provided with a prosthesis 118, which is adapted to occupy the hole 18 created in the pelvis in which the 9 behind the medical device is implanted.
Part 118 of the prosthesis comprises a support member 119 suitable for contact with the pelvis 9 and assistance in carrying a load placed on the medical device from the weight of a human patient in normal use. ..
Normal use is defined as a person uses a natural hip joint.
In addition, the medical device is adapted because it is in contact with the artificial convex hip joint surface 112.
It consists of a locking element 116 made of.
The locking element 116 further comprises anchoring a member 115 adapted to assist the fixation of the locking member 116 to the head femur 5 or the colonic chimney femur 6. And that of the turn fixes the artificial convex hip joint surface 112.
The artificial convex hip joint surface 112 is secured to a mounting rod 113 consisting of threads 114 corresponding to the threads of the nut 120 in association with the prosthetic part 118.
The medical device is provided with a plurality of channels 1105 adapted to lubricate the artificial contact surface 112.
The plurality of channels 1105 lubricate the artificial contact surface 112 from the reservoir 1108, thereby lubricating the plurality of channels 1105 to be fully integrated on the artificial contact surface 112 of the medical device for lubrication of the hip joint. It is connected to each by a conduit 1106 adapted to carry the fluid.

When the medical device is placed in the hip joint, FIG. 16 shows the medical device according to FIG.
The first artificial contact surface 112, which has a convex shape toward the center of the hip joint, is placed on the second artificial contact surface 109, which has a concave shape toward the center of the hip joint.
A second artificial contact surface 109 is placed, the colon chimney femur 6 of the head 5 and femur bone.
By a locking element 116 consisting of a surface layer 117 towards a first artificial convex contact surface layer 112 that is fixed and fixed in.
The medical device is provided with a plurality of channels 1105 and thereby the hip joint, in which the 1106 is connected to a centrally located conduit in the medical device for supplying the lubricating fluid to the artificial contact surface 112 and lubricates the artificial contact surface 112. Has been done.

FIG. 17 shows that the prosthetic part 118 is provided in the hole 18 of the pelvis 9.
Part 118 of the prosthesis comprises a support member 119 suitable for contact with the pelvis 9 and assistance in carrying a load placed on the medical device from the weight of a human patient in normal use. ..
18 shows that another embodiment of the medical device of the reverse embodiment in which the portion of the medical device consisting of the artificial concave hip joint is raised was placed in the head 5 and the colon chimney femur 6.

The figure comprises a plurality of lubricant channels 1105 connecting to conduit 1106b, which determines the fluid connection tube between medical devices, and a reservoir located in the cancellous bone of the colon chimney femur 6.
The reservoir is located in association with the femoral bone 7 according to the embodiment of FIG. 18 and has a larger trochanter 1
Adapted to be replenished by injection port 1107 under 186.
The reservoir device (and its function) is described in more detail with respect to FIGS. 9a and 9b.
FIG. 18 further shows Prosthesis No. 118 when secured to the pelvis 9 using screws 121.
The screw can be assisted or replaced with an adhesive that could be applied to the screw or to the connection at the surface S between the prosthesis and the pelvis 9.

FIG. 19 shows the right leg of a human patient.
A femoral bone 102 having a peripheral portion consisting of a lateral joint hill 105, a medial joint hill 106 and a region between the lateral joint hill and the medial joint hill.
The peripheral portion of the femur bone 102 consists of the contact surface of the knee joint.
The knee joint further consists of the patella 101. And it is a triangular bone that speaks clearly by the femur 102 and covers and protects the knee joint.
The knee joint also consists of mini sci 107, 108, which are cartilage elements within the knee joint that serve as an articulation plane to protect the ends of the bone from rubbing against each other.
The mini sci 107, 108 also act as a shock absorber for the knee joint. Then, it absorbs the shock from the movement of the human patient.
Two menisci 107, 108 are located on each knee, medial meniscus 107 and lateral meniscus 108.
In patients with osteoarthritis, the working meniscus 107, 108 is worn down as the clearly expressed surface layer, ie, brings about the surface layer, and in extreme cases the bone can be exposed at the joint. ..
The knee joint is protected by a knee joint capsule (also known as a knee joint capsule or a capsular ligament of the knee joint).
Knee capsules are wide and sloppy;
Thinning forward and side;
It then includes the patella 101, ligaments, meniscus 107, 108 and sac (a small fluid-filled sac made of white fibrous tissue).
The knee joint capsule is a synovial fluid that is separated by a fat precipitate on the anterior side and has a fibrous membrane and a poster.
Includes i-orly.

FIG. 20 reveals to the knee joint that 116a was provided to the peripheral portion of the femoral bone 102 and the proximal portion of the tibial bone 104 when the artificial knee joint surfaced 130.
Lateral medial channels 125a, b provide the knee joint with a contact surface and thereby a lubricating fluid to reduce friction in the knee joint.

FIG. 21 shows the body of a human patient in a front view in which the reservoir device 127 is subcutaneously inserted into the abdomen of a human patient.
The storage device according to this embodiment is a battery 1 for pumping fluid from the conduit storage 129 to the channel 125 supplying the artificial contact surface of the knee joint having the lubricating fluid.
It comprises an operating device in the form of a pump 130 driven by 28.
The reservoir device is attached to the muscle or fascial tissue 1181 of the abdominal wall by the reservoir device and the muscular or fascial 1181 tissue anchored between the injection ports 1107 arranged outside the muscular or fascial tissue 1181. Fix.

FIG. 22a shows where the medical device consists of an artificial knee joint, where the surface layer of 115 fixes the lateral joint hill 106 inside the midline, lateral or knee joint (which is the terminal portion of bone 7 of the femur). Clarify what to do in the examples.
The medical device according to this embodiment has multiple channels 1105 for lubricating an artificial contact surface.
Multiple channels consisting of, in turn, at a conduit 1106 in a fluid connection having a reservoir 1108 consisting of an injection port 1107 for replenishing the reservoir or pressurizing the lubricating fluid contained in the reservoir 1108. In a fluid connection with each.
The conduit 1106 carries the lubricating fluid through channel 1105 to inlet 1123 for deeper distribution.

FIG. 22b shows the knee joint in the side view when a medical device consisting of an artificial contact surface 1102 is provided to the proximal portion of the tibial bone 104. And the fibula bone 103 and it occupy the lower part of the leg.
The artificial knee joint surface is provided with a plurality of channels 1105 in a fluid connection having an adaptive conduit 1106 to be configured as a transport lubricating fluid from the reservoir 1108.
The reservoir 1108 is located on the posterior flank of the tibial bone 104 and is fixed to the tibial bone 104 according to the embodiment of FIG. 22b, injecting a lubricating fluid into the reservoir 1108 and / or into the reservoir 1108. It consists of an injection port 1107 for pressurizing the included lubricating fluid.
The conduit 1106 carries the lubricating fluid through channel 1105 to inlet 1123 for deeper distribution.

FIG. 23 shows in more detail a medical device for knee osteoarthritis.
To lubricate the contact surface of a medical device, the medical device consists of a plurality of channels 1105 arranged along the artificial contact surface of the medical device.
Channel 1105 connects to conduit 1106 for transport of lubricating fluid along the artificial contact surface 1101 of the medical device.
The conduit 1106 carries the lubricating fluid through channel 1105 to inlet 1123 for deeper distribution.

FIG. 24 shows a cross-sectional side view of a medical device showing channels 1105 that are fully integrated on the artificial contact surface, and connected to each, conduit 1106 lubricates the artificial contact surface of the medical device. As expected, it supplies 1105 channels with lubricating fluid.
The conduit 1106 carries the lubricating fluid through channel 1105 to inlet 1123 for deeper distribution.

FIG. 25a shows a medical device for knee osteoarthritis in a human patient, which comprises the medical device. And some medical device units 119 that adapt to each and to connect to the medical device.
Form the basis of the 118th part by a mechanical fixing element 120 that supplies a conforming shape between the plurality of medical device parts 119 and the 118th part of the base.
The 118th portion of the medical device base further comprises a fixation portion 117 adapted to supply the mechanical fixation of the medical device to the bones of the human body (eg, the proximal portion of the tibial bone).
Further, the medical device base 118th part is provided with a channel for supplying a lubricating fluid, and is configured as an artificial contact surface of the knee joint.

Upon assembly, FIG. 25b shows the medical device according to FIG. 25a.

FIG. 26 shows the medical device according to FIGS. 25a and 25b when the medical device is fixed to the tibial bone 104.

FIG. 27 shows the proximal portion of the tibial bone when a medical device consisting of an artificial contact surface 116 is fixed to the tibial bone 104.
Channel 1105 on the artificial contact surface provides a fluid connection tube between channel 1105 of the medical device and the first and second reservoirs 1108 located in the intermediate laterally superior tibial bone 1104. It is connected to the conduit 1106.
The conduit further connects to an infusion port 1107 located on the middle side of the pelvis for replenishing and / or pressurizing the first and second reservoirs.
The reservoir 1108 is adapted to place the lubricating fluid under pressure according to the illustrated embodiment of FIG. Thereby, a lubricating fluid is squeezed from channel 1105 onto the artificial contact surface to lubricate the knee joint.
For this purpose, in order to squeeze the lubricating fluid, the reservoir 1108 consists of a spring 1109 associated with a movable wall portion in the form of a piston 1110.

FIG. 28 shows a human patient in the front view when the implantable lubricator 120 is inserted.
The implantable lubricator 120 is adapted for continuous infusion of lubricating fluid, intermittently or when required for said hip joint.
Two interconnected devices 121, 122 are provided to match the implantable lubrication system with the illustrated embodiment of FIG.
The two, which are interconnected devices, have the abdomen of a human patient placed inside and the conduit 1106.
In relation to the hip joint.

FIG. 29 shows an implantable lubrication system 120. It can then be used in more detail in combination with any of the medical devices described herein.
According to the illustrated embodiment, the implantable lubrication system consists of a first device 121 consisting of a pumping member 123 adapted to pump a lubricating fluid from the reservoir 1108 to the hip joint area. Become.
In addition, the first device 121 is provided with an injection port 1107 to fill the reservoir 1108 from outside the human body where no surgical procedure must be performed.
The injection port 1107 is provided with a self-sealing membrane that is penetrable with an attached needle and is configured to resemble a syringe.
The deeper first device 121 is provided with a receiver of radio energy 124, preferably consisting of a coil.
The receiver of wireless energy is used to charge the battery 126.
According to this embodiment, the implantable lubricator 120 further comprises a second device 122, which in turn consists of a battery 126 and a fluid reservoir 1108.
The lubricating fluid 128 oils from the reservoir 1108 by a first device 121 having a device pumping water, by a conduit 1106, and by which it oils the hip joint surface or the artificial contact surface of the implantable medical device. Pumped to the area of the hip that helps to rub.
The lubricating fluid is preferably a biocompatible lubricating fluid such as hyaluronic acid.

According to an embodiment in which the implantable lubrication system is a person inlet 130 consisting of a lubricated joint and a circulation lubrication system to the person outlet 131, FIG. 30 is any of the medical devices herein. An implantable lubrication system adapted for use in.
Preferably, the system is a continuous lubrication system in which the pumped member 123 continuously circulates the lubricating fluid 128 inside the hip joint.

FIG. 31 shows an implantable lubrication system for turning lubrication adapted for use in any of the medical devices herein. There, the lubrication system further comprises a filter member 132 for filtering the lubricating fluid.
The filter adapts to be self-cleaning, and externally, the filtering item is located at the processing channel 133, also in the abdomen of a human patient, or in a container attached to the processing channel 133.
With the filtration of the lubricating fluid 128, the circulating lubrication system can operate for a long period of time without the need for any surgical procedure.

FIG. 32 shows the lubricating fluid of FIG. 29 when lubricating a implantable medical device made of an artificial contact surface 45 by providing the lubricating fluid 128.

FIG. 33a shows a lubrication system. And it is the retractable needle 13 whose lubrication system is said.
According to another embodiment consisting of a device 1310 consisting of a retractable needle 1311 fixed to an operating system for operating 11, adapted for use in combination with any of the medical devices herein. Can be done.
The needle is a self-sealing membrane 131 placed on the pelvis 9 for injecting lubricating fluid into the hip joint.
Adapt to penetrate 4.
Conduit 1106 has lubricating fluid from additional reservoirs that can be inserted from the injection port and / or subcutaneously, or is adapted to supply the device 1310 in the void of the body.

FIG. 33b shows a lubrication system in which the retractable needle 1311 is in its advanced position by the operating device in which the retractable needle 1311 was operating.
The needle is thereby pierced through the self-sealing membrane 1314 and placed in a position where the lubricating fluid can be injected.

FIG. 34 illustrates a system for treating a disease consisting of the device 10 of the present invention placed in the abdomen of a patient.
The planted N-ergy changing device 1002 is adapted to supply the energy consuming components of the device having energy through the power supply line 1003.
The external energy-transmission device 1004, which non-invasively energizes the device 10, transmits energy by at least one radio energy signal.
The planted energy converter 1002 converts energy from the radio energy signal into the amount of power supplied via the power supply line 1003.

For example, the planted energy converter 1002 may also consist of other components:
The transmission of signals and / or coils for receiving and / or transmitting signals, antennas and / or signals for receiving, microcontrollers, charge controllers can optionally be energy storage, such as capacitors, one or more sensors (eg, one or more). Signal a sensor consisting of a temperature sensor, pressure sensor, position sensor) and others. And the transceiver (motor)
Optionally includes a motor controller, pump and other parts for controlling the operation of the medical implant.

The radio energy signal may include a wave signal selected from the following parts:
Sound signals, ultrasonic signals, electromagnetic wave signals, infrared light signals, visible light signals, ultraviolet light signals, laser light signals, microwave signals, radio wave signals, X-ray radiation signals and gamma radiation send signals.
Alternatively, the radio energy signal may include an electrical or magnetic field or a combined electrical and magnetic field.

The wireless energy-transmission device 1004 may transmit a carrier signal to carry the wireless energy signal.
This type of carrier signal may include a combination of digital, analog or digital analog signals.
In this case, the radio energy signal includes an analog or digital signal or a combination of analogs and digital signals.

Generally speaking, the energy converter 1002 is energy-to the second form of energy.
The first form of radio energy transmitted by transmission device 1004 is converted and provided. And it is generally different from the first form of energy.
The planted device 10 can be operated in response to a second form of energy.
As the energy converter 1002 converts the first form energy transmitted by the energy-transmission device 1004 into the second form energy, the energy converter 1002 may directly drive the device having the second form energy. ..
The system may further include an implantable accumulator. There, the second form energy is at least partially used to charge the accumulator.

Alternatively, as the radio energy is transmitted by the energy-transmission device 1004, the radio energy transmitted by the energy-transmission device 1004 may be used to drive the device directly.
Where the system consists of operating devices that operate the device, the radio energy transmitted by the energy-transmission device 1004 directly drives the operating device to generate kinetic energy for the operation of the device, as described below. May be used.

The first form of radio energy may consist of sound waves, and the energy converter 1002 may include piezoelectric elements for converting sound waves into electric energy.
The second form of energy may consist of a direct current or pulsating direct current (or a combination of direct current and pulsating direct current) or an electric energy in the form of an alternating current or a direct and alternating current combination. unknown.
Devices typically consist of electrical components that are energized by an electrical energy source.
Other portable electrical components of the system may be at least one voltage level guard or at least one constant current source guard associated with the electrical components of the device.

Optionally, those with the first form of energy and the second form of energy are from magnetic energy, kinetic energy, solid energy, chemical energy, radiated energy, electromagnetic energy, photographic energy, nuclear energy or thermal energy. May be.
Preferably, the first form of the second form and those with energy of energy are non-magnetic, non-moving, non-chemical, non-sounding, non-nuclear-carrying or non-thermal.

The energy-transmission device may be controlled to release the electromagnetic radio energy from outside the patient's body, and the released electromagnetic radio energy is used to operate the device.
Alternatively, the N-ergy-transmission device is controlled to release non-magnetic radio energy from outside the patient's body, and the released non-magnetic radio energy is used to operate the device.

The external energy-transmission device 1004 also includes a wireless remote control device having an external signal transmitter for transmitting radio control signals to control the device non-invasively.
The control signal is received or printed out by the planted signal receiver which may be incorporated into the planted energy converter 1002.

The radio control signal may include frequency (amplitude) or may carry out a modulated signal or a combination thereof in stages.
Alternatively, the radio control signal may be an analog or digital signal or a combination of analogs and digital signals.
Alternatively, the radio control signal consists of an electrical or magnetic field or a combined electrical and magnetic field.

The wireless remote control device may transmit a carrier signal to carry the wireless control signal.
This type of carrier signal may include a combination of digital, analog or digital analog signals.
Where the control signal is analog or contains a digital signal or a combination of analogs and digital signals, the wireless remote control device preferably sends a digital or electromagnetic carrier signal to carry the analog control signal.

FIG. 35 illustrates the system of FIG. 34 in the form of a less differentiated block diagram showing device 10 (energy converter 1002 driving device 10 via power supply line 1003). External Energy-Transmission Device 1004 (Patient Skin 1)
005) is usually indicated by a vertical line and cuts the inside of the patient to the right of the line to something that is separated by a line from the outside.

FIG. 36 shows the same embodiment of the present invention as that of FIG. 35. However, the following cases are excluded-for example, a retracting device in the form of an electric switch 1006 that can be operated by the energy of polarization is implanted in the patient to reverse the device 10.
When the switch is actuated by the polarization energy, the radio remote control of the external energy-transmission device 1004 sends a radio signal that the carry has polarized the energy, and the planted energy converter 1002 is radio. The polarization energy is converted into a polarization current for operating the electric switch 1006.
The electric switch 1006 reverses the function performed by the device 10 when both polarities of the current are transferred by the device 1002 changing the planted N-ergy.

FIG. 37 shows the same embodiment of the present invention as that of FIG. 35. However, the following cases are excluded-Device 1
An operating device 1007 implanted in the patient to operate 0 is provided between the planted energy conversion device 1002 and the device 10.
This operating device can be in the form of a motor 1007 (eg, an electric servomotor).
As the remote control of the external energy-transmission device 1004 sends a radio signal to the receiver of the planted energy converter 1002, the motor 1007 is driven by energy from the planted energy converter 1002.

FIG. 38 shows the same embodiment of the present invention as that of FIG. 35. However, the following cases are excluded-it also consists of an operating device in the form of an assembly 1008 including a motor / pump unit 1009, and the fluid reservoir 1010 is implanted in the patient.
In this case, the device 10 is hydraulically operated, i.e., the hydraulic fluid is the motor / pump unit 100 from the fluid reservoir 1010 to the device 10 by the conduit 1011 to operate the device
Pumped by 9, and the hydraulic fluid is pumped back by motor / pump unit 1009 from device 10 to fluid reservoir 1010 to return the device to its initial position.
The planted energy converter 1002 converts the radio energy into a current (eg, a polarization current) for driving the motor / pump unit 1009 via the power supply line 1012.

It is also assumed that the operating device comprises an air operating device instead of the hydraulically operated device 10.
In this case, the working fluid can be compressed air used for regulation, and the fluid reservoir is replaced with an air chamber.

In all of these embodiments, the energy converter 1002 may include a rechargeable accumulator such as a battery or capacitor to be entrusted by radio energy to any energy consuming part of the system. Also supplies energy.

Alternatively, the wireless remote control device described above may be replaced with manual control of any implant, which is probably indirect contact by the patient's hand (eg, a pressing button placed under the skin).

FIG. 39 consists of an external N-ergy-transmission device 1004 having a hydraulically operated case and its wireless remote control device (device 10) of the planted energy converter 1002, the water control valve shift device 1014. Hydraulic fluid reservoir 1 in the form of
013, an embodiment of the present invention further comprising a motor / pump unit 1009 and a retracting device is shown. And everything is planted in the patient.
Of course, hydraulic operation can be easily performed by just changing the direction in which the water is pumped, and the water control valve may therefore be omitted.
Remote control may be a device that is separated from or included in the external energy-transmission device.
The motor of the motor / pump unit 1009 is an electric motor.
In response to a control signal from the wireless remote control device of the external energy-transmission device 1004, the device 1002 changing the planted N-ergy has energy from the energy carried by the control signal Motor / pump unit 1009. To drive. Thereby, the motor / pump unit 1009 becomes a hydraulic fluid reservoir 1013.
And the hydraulic fluid is weighed and distributed between the devices 10.
The remote control of the external energy-transmission device 1004 is the water control valve shift device 10.
14 from the hydraulic fluid reservoir 1013 to the device 10 for the fluid to operate the device One direction pumped by the motor / pump unit 1009 and behind the device 10 to the hydraulic fluid reservoir 1013 for the fluid to return the device to its initial position Control to shift the hydraulic fluid flow direction between the other opposite directions pumped by the motor / pump unit 1009.

FIG. 40 shows the wireless remote control device, the device 10, and the planted energy conversion device 1.
002, planted built-in controller 1015 controlled by wireless remote controller of external energy-transmission device 1004, planted accumulator 1016
And an embodiment of the present invention comprising an external N-ergy-transmission device 1004 having a planted capacitor 1017 is shown.
The built-in control device 1015 is an energy conversion device 100 in which the accumulator 1016 is planted.
Arrange the accumulation of electric energy received from 2. It then supplies energy to the device 10.
External Energy-In response to a control signal from the wireless remote control of the transmission device 1004, the built-in control device 1015 also releases energy from the accumulator 1016 and energy or directly via transmission lines 1018 and 1019 to transfer what is released. Transmission line 1020
The amount of power transferred from the planted energy converter 1002 via (capacitor 1017),
It stabilizes transmission line 1019 for current, transmission line 1021 and operation of device 10.

The built-in controller is preferably programmable from outside the patient's body.
In a preferred embodiment, the built-in controller controls the device 10 at a pre-programmed time-on schedule or detects any possible physical parameters of the patient or any functional parameters of the system. It is also programmed to input from the sensor.

According to the options, the capacitors 1017 of the embodiments of FIGS. 40 and 10 may be omitted.
According to other options, the accumulator 1016 in this embodiment may be omitted.

FIG. 41 shows the same embodiment of the present invention as that of FIG. 35. However, the following cases are excluded-Device 1
A battery 1022 for supplying energy to the operation of 0 and an electric switch 1023 for switching the operation of the device 10 are implanted in the patient.
The electric switch 1023 may also be controlled by remote control and also the energy supplied by the N-ergy changing device 1002 planted to switch from off mode (battery 1022 is not in use). The above mode (battery 1022 supplies energy to the operation of device 10) so that it may be activated.

FIG. 42 shows the same embodiment of the present invention as that of FIG. 41. However, the following cases are excluded-external energy-the built-in control device 1015, which can be controlled by the wireless remote control device of the transmission device 1004, is implanted in the patient.
In this case, the electric switch 1023 is an energy conversion planted to switch from the off mode (the wireless remote controller is prevented from controlling the built-in controller 1015, and the battery is not in use) to the standby operating mode. It is operated by the energy supplied by the device 1002. There, the remote control uses the built-in control device 1015 as the device 1.
It can be controlled to release the electric energy from the battery 1022 for 0 operation.

FIG. 43 shows the same embodiment of the present invention as that of FIG. 42. However, except in the following cases-accumulator 1016 is substituted for battery 1022, and the planted components are interconnected differently.
In this case, the accumulator 1016 stores energy from the planted energy converter 1002.
In response to the control signal from the wireless remote control of the external energy-transmission device 1004, the built-in control device 1015 controls the electric switch 1023 to switch from the off mode (accumulator 1016 is not in use) in the above mode (the accumulator 1016 is not in use).
The accumulator 1016 supplies energy to the operation of the device 10).
The accumulator may be combined or replaced with a capacitor.

FIG. 44 shows the same embodiment of the present invention as that of FIG. 43. However, the following cases are excluded-Battery 1
022 is also implanted in the patient, and the implanted components are interconnected differently.
External Energy-Energy for the built-in control device 1015 to activate the electrical switch 1023 to switch the accumulator 1016 from off mode (battery 1022 not in use) in response to a control signal from the wireless remote control of the transmission device 1004. Mode above to control to eject (battery 1022 powers the operation of device 10).

Alternatively, the electric switch 1023 is in the off mode (the wireless remote control device is the battery 102).
It may be actuated by the energy supplied by the accumulator 1016 to switch from (not in use) to standby operating mode, which is prevented from controlling 2 to supply power. There, the wireless remote control device can control the battery 1022 to power the operation of the device 10.

It should be understood that switch 1023 and all other switches in the present application must be construed in its broadest embodiment.
This means a transistor, MCU, MCPU, ASIC, FPGA or DA converter, or any other electronic component or circuit may very much switch power on / off.
Preferably, the switch is controlled from outside the body or by an implanted built-in controller.

FIG. 45 shows the same embodiment of the present invention as that of FIG. 41. However, the following cases are excluded-motor 1007, mechanical retracting device in the form of gearbox 1024, and gearbox 1
A built-in controller 1015 for controlling 024 is also implanted in the patient.
The built-in control device 1015 controls the gearbox 1024 to reverse the function performed by the device 10 (mechanically operated).
A uniform plant collector is supposed to electronically switch the direction of the motor.
The gearbox interpreted in its broadest embodiment may represent a servo device that reserves force for a longer stroke operating device to do.

FIG. 46 shows the same embodiment of the invention as that of FIG. 52, except that the planted components are differently interconnected.
As described above, in this case, the built-in control device 1015 is driven by the battery 1022 that activates the electric switch 1023 switched by the accumulator 1016 (optimally a capacitor).
The electric switch 1023 can control the battery 1022 supplied by the built-in control device 1015 to its mode at any time, and supplies energy for the operation of the device 10.

FIG. 47 graphically shows a possible combination of planted components of a device that achieves various communication options.
Basically, there is a device 10, a built-in control device 1015, a motor or pump unit 1009, and an external energy-transmission device 1004 includes an external wireless remote control device.
As already described above, the wireless remote controller transmits a control signal received by the built-in controller 1015. And it controls various planted components of the device one after another.

A feedback device (preferably consisting of a sensor or measuring device 1025) may be implanted in the patient to detect the patient's physical parameters.
Physical parameters are selected from the group consisting of at least pressure, volume, diameter, stretching, stretching, dilation, exercise, bending, elasticity, muscle contraction, nerve impulses, body temperature, blood pressure, blood flow, beating and breathing. It may be someone.
The sensor may detect any of the above physical block parameters.
For example, the sensor may be a pressure or motility sensor.
Alternatively, the sensor 1025 may be arranged to detect functional parameters.
Functional parameters may correlate with the transfer of energy to entrust to the planted energy source, or at least include some who are selected from the group of parameters to consist;
Electricity, any electrical parameter, pressure, volume, diameter, range, extension, expansion, movement,
Bending, elasticity, temperature and flow.

Feedback is sent to the external controller via the internal controller, to the internal controller, or
May be sent out, preferably.
Feedback may be emitted from the body via an energy transfer system or a separate communication system with a receiver and transmitter.

Built-in controller 1015 or external energy-transmission device 10
The external wireless remote control device of 04 may control the device 10 in response to a signal from the sensor 1025.
The transceiver may be coupled with a sensor 1025 to send information about the detected physical parameters to an external wireless remote controller.
The wireless remote controller may consist of a signal transmitter or transceiver, and the built-in controller 1015 may consist of a signal receiver or transceiver.
Alternatively, the wireless remote controller may consist of a signal receiver or transceiver, and the built-in controller 1015 may consist of a signal transmitter or transceiver.
The transceiver, transmitter and receiver described above are located outside the device 10 from inside the patient's body.
May be used to send information or data related to.

Information related to charging the battery 1022 may be fed back where the motor / pump unit 1009 and the battery 1022 for driving the motor / pump unit 1009 are inserted.
To be more accurate. At that time, imposing the energy supplied by the feedback and energy at which the information related to the charging method is transmitted to the battery or accumulator varies accordingly.

FIG. 48 shows another embodiment in which the device 10 is tuned from outside the patient's body.
The system 1000 is provided with a battery 1022 to be connected, and an electric switch 10 under the skin.
It is configured as a device 10 that has passed through 26.
Thus, the standard device 10 is performed non-invasively by manually pressing a subcutaneous switch. Thereby, the operation of the device 10 is switched on / off.
An additional part, which is a simplification of the examples shown and is disclosed in this application.
It goes without saying that, for example, a built-in controller or any other part can be added to the system.
Two subcutaneous switches may also be used.
Performance is reversed in some preferred embodiments where the implanted switch sends information to the built-in controller performing a particular pre-determined performance and when the patient presses the switch again.

FIG. 49 shows another embodiment. There, the system 1000 consists of a hydraulic fluid reservoir 1013 that is hydraulically connected to the device.
Non-invasive adjustments are performed by manually pressing the fluid reservoir connected to the device.
Alternatively, preferably for hydraulic fluid calibration, the hydraulic fluid reservoir 1013 adapts to work having an injection port for injecting the hydraulic fluid.

The system may include an external data communicator communicating with an external data communicator and a portable internal data communicator.
The internal communicator supplies the external data communicator with data related to the device or patient and / or the external data communicator supplies the data to the internal data communicator.

In a sequence of supplying an accurate amount of energy to the planted internal energy receiver 1002 connected to the planted energy consuming component of device 10, FIG. 50 shows the feedback of the device or system. The patient's body can be sent to information from the inside outside to give information related to at least one functional parameter, or schematic with respect to the placement of the system related to the physical parameters of the patient. Illustrate.
This type of energy receiver 1002 may include an energy source and / or an energy converter.
Briefly, radio energy is an external energy source 100 located outside the patient.
Conducted from 4a and received by an internal energy receiver 1002 located at the patient.
The internal energy receiver adapts directly or indirectly supplies received energy to the energy-consuming components of device 10 via switch 1026.
The energy balance is determined between the energy received by the internal energy receiver 1002 and the energy used for the device 10, and the transmission of radio energy is controlled based on the energy balance then determined. ..
Energy balance thus provides an accurate indication of the correct amount of energy required. And it is sufficient to operate the device 10 properly, except without causing an excessive rise in body temperature.

In FIG. 50, the patient's skin is indicated by the vertical line 1005.
Here, just preferably under the patient's skin 1005, the energy receiver consists of an energy converter 1002 located at the patient.
Generally speaking, the energy converter 1002 implanted subcutaneously or at any other suitable location may be placed on the abdomen, chest, muscular fascia (eg, in the abdominal wall).
The implanted energy converter 1002 is an external energy-transmission apparatus 10 located outside the patient's skin 1005 near the implanted energy converter 1002.
It is adapted to receive the radio energy E transmitted from the external energy source 1004a provided in 04.

As is well known, the radio energy E is usually any suitable trans-skin energy transfer (TET) device (eg, a device containing a primary coil located at an external energy source 1004a and an implanted energy conversion device 1002). It may be transferred by the adjacent secondary coil) placed in.
When the current is supplied by the primary coil, for example after storing the incoming energy in an implanted energy source (eg a rechargeable battery or capacitor), the energy in the form of voltage is the implanted energy of the device. It is induced in a secondary coil that can be used to drive the components that are consuming energy.
However, the present invention is generally not limited to any particular energy transfer technique, TET device or energy source, and any kind of radio energy may be used.

The amount of energy received by the planted energy receiver may be compared to the energy used by the planted components of the device.
The term "energy used" is then understood to include the energy stored by the planted components of the device.
The control device is an external energy source 1004 based on a determined energy balance.
Includes an external controller 1004b that controls a to adjust the amount of transferred energy.
In the hierarchy, the transfer of the correct amount of energy, energy balance and required amount of energy is determined by a determination device that includes a planted built-in control device 1015 connected between the switch 1026 and the device 10.
It may be arranged in this way that the built-in controller 1015 receives various measurements (not the measurement specific characteristics indicated by the device 10) obtained by an appropriate sensor or the like, which is necessary to reflect. The amount of energy required for proper operation of the device 10.
In addition, the patient's current condition is in order to provide a reflecting parameter that may also be detected by an appropriate measuring device or sensor.
Therefore, this type of feature and / or parameter may also be related to the current state of device 10 (eg power consumption, operating mode and temperature), as the patient's condition was reflected, for example, by parameters;
Body temperature, blood pressure, heartbeat and breathing.
Other types of patient physical block parameters and device functional parameters are described elsewhere.

Furthermore, an energy source in the form of an accumulator 1016 is optionally connected to the planted energy conversion device 1002 via the control device used by the device 10 for the stored energy received for the subsequent generations. May be doing.
Alternatively, or in addition, the properties of this type of accumulator may also be measured in the same way, reflecting the amount of energy required.
The accumulator may be replaced with a rechargeable battery, and the measured features may be related to the current state of the battery, any electrical parameters such as energy consumption voltage, temperature, etc. In order to supply sufficient voltage and current to device 10 and avoid further overheating, the batteries, i.e. too little or too much, get the correct amount of energy from the planted energy converter 1002. It is clearly understood that by receiving it must be optimally charged.
The accumulator may also be a capacitor with corresponding characteristics.

For example, battery characteristics may be measured on a regular basis to determine the current state of the battery. It may then be stored as state information for the appropriate storage means of the built-in controller 1015.
Thus, whenever a new measurement is made, the stored battery status information can therefore be updated.
In this way, the state of the battery can be "adjusted" by transferring the correct amount of energy to keep the battery in optimal condition.

Thus, the built-in control device 1015 of the determination device is made by the above-mentioned sensor or measuring device of the energy balance and / or the amount of energy currently required (device 10 (or patient) if used or the planted energy source). Adapt to determine based on the measurements to be taken or any combination thereof (any energy per time device or stored energy).
External control device 1004b. Arranges to transmit the reflecting control signal. In energy to the external signal receiver 1004c connected to, the built-in controller 1015 is transmitted from the determined required amount of external energy source 1004a further connected to the internal signal transmitter 1027. The amount of energy that is then may then be adjusted in response to the receive control signal.

Alternatively, the determination device may include an external control device 1004b.
In this option, sensor measurements can be sent directly to an external controller 1004b where the energy balance and / or the amount of energy currently required can be measured by the external controller 1004b. In this way, the above-mentioned functions of the built-in control device 1015 of the external control device 1004b are integrated.
In that case, the built-in controller 1015 can be omitted, and the sensor measurements are directly fed to the external signal receiver 1004c and the internal signal transmitter 1027 which broadcasts the measurements to the external controller 1004b. ..
The energy balance and the amount of energy currently required can then be measured by an external controller 1004b based on those sensor measurements.

Therefore, the current solution according to the sequence of FIG. 50 uses the feedback of information indicating the required energy, for example the amount of energy received, which is more efficient than the previous solution because it is based on the actual one. Used in the rate of receiving energy compared to the rate of energy used by the energy, energy difference or component planted in the device compared with.
The device may use received energy to consume or store energy in an implanted energy source or the like.
The different parameters mentioned above are thus related and required if used, and then balanced as a tool for determining the actual energy.
However, this kind of parameter may be necessary, especially for any measures taken internally to operate the device.

The internal signal transmitter 1027 and the external signal receiver 1004c are suitable signal transfer means (
It may be done as a separate device using, for example, a radio, IR (infrared) or ultrasonic signal).
Alternatively, the built-in signal transmitter 1027 and the external signal receiver 1004c integrate in the planted energy converter 1002 and the external energy source, respectively, to transmit the reverse control signal in connection with the energy transfer. May be done. And basically the same transmission technique is used.
The control signal may be tuned with respect to frequency, phase or amplitude.

In this way, feedback information may be transferred by separate communication systems, including receivers and transmitters, or may also be aggregated in energy systems. According to the present invention, this kind of integrated information that the feedback and energy system consists of an implantable internal energy receiver for receiving radio energy, an energy receiver with an internal first coil and a first electron. The circuit was connected to a first coil, and an external energy transmitter for conducting radio energy, an energy transmitter with an external second coil and a second electronic circuit were connected to a second coil. The external second coil of the energy transmitter transmits the radio energy received by the first coil of the energy receiver. The deeper system is provided with a power switch for switching the connection of the internal first coil, configured as a first electronic circuit on / off. Feedback information related to entrusting to the first coil is external second
As received by an external energy transmitter in the form of impedance changes in the coil load. At that time, the power switch shifts the connection of the internal first coil to the first electronic circuit on / off.
In implementing this system in the arrangement of FIG. 50, the switches 1026 were separately controlled by the built-in controller or integrated in the built-in controller 1015. It should be understood that the switch 1026 must be interpreted in its broadest embodiment. This means a transistor, MCU, MCPU, ASIC FPGA or DA converter, or any other electronic component or circuit may very much switch power on / off.

To finish, the energy supply device illustrated in FIG. 50 may operate as the main part in the following ways.
The energy balance is first measured by the built-in control device 1015 of the determination device.
The required amount of energy is created by the built-in controller 1015, and the control signal is from the internal signal transmitter 1027 to the external signal receiver 1004c. The reflected control signal transmitted up to, or as mentioned above, the energy balance can be measured by an external controller instead of 1004b, depending on the implementation.
In that case, the control signal may provide measurement results from various sensors.
The amount of energy emitted from the external energy source 1004a then responds to a receive control signal, eg, based on a determined energy balance, external controller 1004b.
Can be adjusted by
This method may be repeated intermittently at specific intervals during the ongoing energy transfer, or may be performed on a somewhat continuous basis during the energy transfer.

The amount of energy transferred can usually be adjusted by adjusting various transmission parameters of the external energy source 1004a (eg, voltage, current, amplitude, wave frequency and pulse characteristics).

This system may also be used to find the optimum location for the external coil with respect to the internal coil and to obtain information about the coupling factor with the coil of the 1TET system that even tunes the system to optimize energy transfer.
Simply comparing the amount of energy in this case moved with the amount of energy received.
For example, if the external coil moves, the coupling factors may change, and the correctly shown motion could cause the external coil to seek out the optimal location for energy transfer. Preferably, the external coil is adapted to adjust the amount of energy transferred to accomplish the feedback information in the determination device. After that, the coupling factor is maximized.

This coupling factor information may also be used as feedback during energy transfer.
In this type of case, the energy system of the present invention comprises an implantable internal energy receiver for receiving radio energy.
An energy receiver with an internal first coil and a first electronic circuit is connected to the first coil and is an external energy transmitter for conducting radio energy, an external second.
The energy transmitter with the coil and the second electronic circuit were connected to the second coil.
The external second coil of the energy transmitter transmits the radio energy received by the first coil of the energy receiver.
This deeper system has a feedback device that transmits the amount of energy received in the first coil as feedback information to the outside, where the second electronic circuit receives the feedback information, and the first and first. Includes a determination device for comparing the amount of energy transferred by the second coil with feedback information related to the amount of energy received in the first coil to obtain a coupling factor with the second coil. It has a feedback. The energy transmitter may control the transmitted energy in response to the resulting coupling factor.

With respect to FIG. 51, although the radio transfer of energy to operate the device was described above to allow non-invasive operation, the device is also operated by the energy associated with the leads. It goes without saying that you can do it. An example of this type is shown in FIG. There, the external switch 1026 interconnects between an external energy source 1004a and an operating device (eg, an electric motor 1007 operating the device 10).
The external control device 1004b controls the operation of the external switch 1026 in order to perform an appropriate operation of the device 10.

FIG. 52 illustrates different embodiments for the methods in which received energy can be supplied to and used by device 10. Similar to the embodiment of FIG. 50, internal energy
The receiver 1002 receives the radio energy E from an external energy source 1004a controlled by the transmission control unit 1004b. The internal energy receiver 1002 may consist of a constant voltage circuit (shown as the dotted box "constant V" in the figure to supply energy to the device 10 at a constant voltage). The internal energy receiver 1002 may further consist of a constant current source circuit (shown as the dotted box "constant C" in the figure to supply energy to device 10 with a constant current source).

The device 10 comprises a part 10a that consumes energy. And it's a motor,
It may be a pump, a regulatory device or any other medical device that requires energy for its electrical operation. The device 10 may further consist of an energy storage device 10b for storing the energy supplied by the internal energy receiver 1002.
Thus, the supplied energy may be consumed by part 10a, which is consuming the energy directly, or may be stored by the energy storage device 10b, or the supplied energy is partial. It may be consumed in, and may be partially stored. The device 10 may further consist of a device 10c that stabilizes the energy to stabilize the energy supplied by the internal energy receiver 1002. Thus, energy may be supplied in a fluctuating manner, as it may be needed to stabilize the energy before it is consumed or stored.

The energy supplied from the internal energy receiver 1002 may be further stored and / or stabilize separate energies located outside the device 10 before being consumed and / or stored by the device 10. It may be stabilized by the device 1028 being operated. Alternatively, the energy stabilizing device 1028 may be integrated in the built-in energy receiver 1002. In any case, the energy stabilizing device 1028 may consist of a constant voltage circuit and / or a constant current source circuit.

50 and 52 show some possible but non-limiting implementation options regarding how the various indicated functional components and elements can be arranged and connected to each. It should be noted that However, skilled people
It is immediately acknowledged that many variations and modifications can be made within the scope of the present invention.

FIG. 53 schematically shows an energy balance or energy balance control system measuring the circuit of a person with a proposed design of a system of control transmission of radio energy. The circuit has an output signal proportionally related to energy imbalance, concentrated at 2.5V. Derivatives of this signal indicate whether the value goes up or down and how quickly this kind of change occurs.
If the amount of received energy is lower than the energy used by the planted components of the device, more energy is transferred and thus delegated to the energy source.
The output signal from the circuit was generally the supply to the A / D converter and was transformed into a digital format. Digital information can then be sent to an external energy-transmission device that is capable of adjusting the level of energy it is transmitted. Another possibility is to use a comparator that compares the energy balance level to the specific maximum and minimum thresholds that are sending information to the external energy-transmission device when the balance drifts out of the maximum / minimum window, fully analog. -To have a system.

Model Figure 53 shows a circuit implementation for a system that transfers energy from outside the patient's body using inductive energy transfer to the implanted energy components of the device of the invention. Inductive energy transfer systems generally use external transmit coils and internal receive coils.
The receiving coil (L1) is included in the model FIG. 36;
The transmitter of the system is excluded.

The implementation of the general concept of energy balance and the way in which information is transmitted to an external energy transmitter can, of course, be done in a number of different ways. The model drawing 53 and the method drawn by the non-imager described above for evaluating and transmitting information must only be considered as an embodiment of the method of implementing a control system.
Circuit details

In FIG. 53, symbols Y1, Y2, Y3 and others symbolize test points within the scope of the circuit. The diagram and the components of each of their values are, of course, the values that work in this particular embodiment, only for those with an infinite number of possible design interpretations.

The energy that drives the circuit is received by the energy receiving coil L1. Energy for the planted components is conducted in this particular case at a frequency of 25 kHz. The energy balance output signal is at test point Y1.

Those skilled in the art will appreciate that the various embodiments of the system described above can be incorporated into many different methods. For example, the electric switch 1006 of FIG. 36 can be incorporated into any of the embodiments of FIGS. 39-45, the water control valve shift device 1014 of FIG. 39 can be incorporated into the embodiment of FIG. 38, and Gearbox 1024 can be incorporated into the embodiment of FIG. Look carefully that a switch can simply mean any electronic circuit or component.

The embodiments described in connection with FIGS. 50, 52 and 53 are methods for controlling and transmitting wireless energy to the implanted energy consuming components of electrically operable devices. Check the device. This type of method and system is defined by the following general terms:

The method is thus provided for the controlled transmission of radio energy supplied to the energy-consuming components of the device planted as described above. Radio energy E is transmitted from an external energy source located outside the patient to provide internal energy located at the patient.
Received by the receiver. The internal energy receiver is then connected to the planted energy that is consuming the components of the device that directly or indirectly supplies the received energy to it. The energy balance is determined between the energy received by the internal energy receiver and the energy used for the device.
The transmission of radio energy E from an external energy source is the energy determined from it.
It is controlled based on the balance.

Radio energy may be inductively conducted from the primary coil of the external energy source to the secondary coil of the internal energy receiver. Changes in energy balance may be detected to control the transmission of radio energy based on the changes in detected energy balance. Differences may also be detected between the energy received by the internal energy receiver and the energy used for the medical device. And
Control the transmission of radio energy based on the detected energy difference.

When controlling an energy transmission, the amount of radio energy transmitted may decrease if the detected energy balance change means an increase in energy balance or vice versa. The decrease / increase in energy transmission may further correspond to the rate of change in detection.

If the detected energy difference means that the received energy is greater than the energy used or vice versa, the amount of radio energy transmitted may be further reduced. The decrease / increase in energy transmission may then correspond to the magnitude of the detected energy difference.

As mentioned above, the energy used for a medical device may be consumed to operate the medical device and / or may be stored in at least one energy storage device of the medical device.

When the electrical and / or physical parameters of the medical device and / or the physical block parameters of the patient are determined, energy is conducted for consumption and storage according to the transfer rate per time device determined based on the parameters. May be. The total amount of energy transmitted may also be determined based on the above parameters.

Differences are detected between the total amount of energy received by the internal energy receiver, and the total amount of energy consumed and / or stored and detection differences is at least one measured in relation to said energy balance. When related to the time-lapse integration of electrical parameters, the integration may be determined due to the monitored voltage and / or current associated with the energy balance.

When the inducer is determined over the time of the measured electrical parameters associated with the amount of energy consumed and / or stored, the inducer is of the monitored voltage and / or current associated with the energy balance. May be decided for. The transmission of radio energy from an external energy source may be controlled by applying it from a first electrical circuit to an external energy source electrical pulse to conduct the radio energy.

Then, the electrical pulse leads and has a trailing edge, the continuous lead of the electrical pulse and the first time interval and / or the continuous pull between the trailing edges and the electrical pulse ( And changing the length of the second time interval between the leading edges of the transmitted radio energy), the transmitted energy generated from the electrical pulses to have the various forces, the first and / Or change the force according to the length of the second time interval.

In that case, the frequency of electrical pulses may be substantially constant when changing the first and / or second time interval. When applying the electrical pulse, the electrical pulse may remain invariant, except that it changes the first and / or second time interval.
When changing the first and / or second time interval, the amplitude of the electrical pulse may be substantially constant. Further, the electrical pulse may be diverse by simply leading the electrical pulse continuously and changing the length of the first time interval between the electrical pulse and the trailing edge.

A series of two or more electrical pulses may be delivered in succession. There, when applying pulse continuity, it has a first electrical pulse at the beginning of the pulse train.
And a train with a second electrical pulse at the end of the pulse train, two or more pulse trains may be continuously supplied. There, the length of the second time interval between the contiguous trailing edge of the second electrical pulse of the first pulse train and the main edge of the first electrical pulse of the second pulse train varies. ..

When applying an electrical pulse, the electrical pulse may have a substantially stable current and a substantially constant voltage. The electrical pulse may also have a substantially stable current and a substantially constant voltage.
In addition, electrical pulses may also have a substantially constant frequency.
The electrical pulses in the pulse train may also have a substantially constant frequency.

The circuit is shaped by a first electrical circuit, and an external energy source may have a first characteristic time or a first time constant, and when the transmitted energy is effectively altered. , This type of frequency time may be a constant or shorter first characteristic time or time range.

A system consisting of devices as described above is also provided for the control and transmission of radio energy supplied to the planted energy thus consuming the components of the device.
In the broadest sense, the system consists of a control device for controlling the transmission of radio energy from the energy-transmission device and an implantable internal energy receiver for receiving the transmitted radio energy. The internal energy receiver is then connected to a component that is consuming the portable energy of the device for the received energy that it is supplying directly or indirectly to it. Deeper systems are devices based on the energy balance measured by the decision device and the decision device adapted to determine the energy balance between the energies received by the internal energy receiver (the control device is an external energy-transmission device). It comprises the energy used for the implantable energy consuming components (which control the transmission of radio energy from).

In one embodiment where at least one battery may be part or replace device 1002, the device 10 on the power supply line is changing the energy to supply energy.
In one embodiment, the battery is not rechargeable.
In another embodiment, the battery is rechargeable.
The battery supply may, of course, be equipped with both remote controls and may be incorporated into the device.

In addition, the system may consist of one of the following:

A primary coil of an external energy source adapted to inductively transmit radio energy to the secondary coil of an internal energy receiver.

The determination device adapts to detect changes in energy balance, and the control device controls the transmission of radio energy based on the changes in detected energy balance.

The determination device adapts to detect the difference in energy received by the internal energy receiver and the energy used for the component consuming the device's portable energy, and the control device adapts to the detected energy difference. Control the transmission of radio energy based on.

If the detected energy balance change means that the energy balance is increasing, the control device controls the external energy-transmission device to reduce the amount of radio energy transmitted, and vice versa. .. There, the decrease / increase in energy transmission corresponds to the rate of change in detection.

If the detected energy difference means that the received energy is greater than the energy used or vice versa, the control device controls the external energy-transmission device to reduce the amount of radio energy transmitted. There, the decrease / increase in energy transmission corresponds to the magnitude of the detected energy difference.

The energy used for the device is consumed to operate the device and / or is stored in at least one energy storage device of the device.

Where the electrical and / or physical parameters of the device and / or the physical block parameters of the patient are determined, the energy-transmission device consumes and stores according to the transfer rate for the time device measured by the determination device based on the parameters. Transmit energy for.
The determination device also determines the total amount of energy transmitted based on the parameters.

When a difference is detected between the total amount of energy received by the internal energy receiver and the total amount of energy consumed and / or stored, and the detection difference is at least one measurement related to energy balance. The time integration of the electrical parameters, the determination that the device determines the integration for the monitored voltage and /
Or it is related to the current related to energy balance.

When the inducer is determined over the time of the measured electrical parameters associated with the amount of energy consumed and / or stored, the determination device is responsible for the monitored voltage and / or current associated with the energy balance. Determine the inducer for.

The energy-transmission device consists of coils placed externally to the human body, and electrical circuits are provided to drive external coils that have electrical pulses to conduct radio energy.
The electrical pulse has a lead and a trailing edge, and the electrical circuit is continuously pulled to change the power one with the transmitted radio energy and between the leading edge of the electrical pulse. Adapted to lead continuously and to vary the first and / or second time interval between trailing edges.
As a result, the energy receiver receiving the transmitted radio energy has various forces.

The electrical circuit is adapted to eject an electrical pulse because it remains invariant except that it changes the first and / or second time interval.

The electrical circuit has a time constant and is adapted to change the first and second time intervals in the range of only the first time constant. As a result, the transmit power on the coil varies when the length of the first and / or second time interval varies.

Because the electrical circuit is diverse by simply leading the electrical pulse continuously and by only varying the length of the first time interval between it and the trailing edge, it emits the electrical pulse. Adapt to.

The electrical circuit subsequently supplies a series of two or more electrical pulses, said train having the first electrical pulse at the beginning of the pulse train and the second electrical pulse at the end of the pulse train. Adapt to, and

The length of the second time interval between the contiguous trailing edge of the second electrical pulse of the first pulse train and the major edge of the first electrical pulse of the second pulse train is the length of the first electronic circuit. It is diverse depending on.

Electrical circuits are adapted to provide electrical pulses as pulses with substantially constant height and / or amplitude and / or intensity and / or voltage and / or current and / or frequency.

The length of the first and / or second time interval because the electrical circuit has a time constant and adapts to vary the first and second time intervals in the range of only the first time constant. When is diverse, what is transmitted is diverse to drive the first coil entirely.

The electrical circuit contains the first time constant or changes the length of the first and / or second time interval only within a range located relative to the first time constant. Adapted to provide electrical pulses. Then, it is compared with the magnitude of the first time constant.

FIG. 54-57 is shown in a more detailed block diagram of four different methods of driving the implanted device according to the invention, either hydraulically or by air action.

FIG. 54 shows the system as described above.
The system includes an implanted device 10, an additional standard storage section 1013, a one-way pump 1009, and alternating valves 1014.

FIG. 55 shows the device 10 and the fluid reservoir 1013.
By moving the standard reservoir wall or resizing the same thing in any other way, the adjustment of the device is any valve (free passage of fluid by moving the reservoir wall at just any time). It may be executed without it.

FIG. 56 shows device 10, bidirectional pump 1009 and standard storage section 1013.

FIG. 57 shows a block diagram of a reversing servo device having a first closed system controlling a second closed system. The servo device includes a standard storage unit 1013 and a servo storage unit 1050. The servo storage 1050 controls the mechanically implanted device 10 via the machine interconnect 1054. The device has an expandable / co-wisdomable cavity. This cavity is preferably the working fluid supplied by the foamed or contracted side from the larger adjustable reservoir 1052 of the fluid connection with the device 10. Alternatively, the cavity contains a compressible gas. It could then be compressed and expanded under the control of servo reservoir 1050.

The servo storage section 1050 can also be a section of the device itself.

In an embodiment, a standard reservoir is placed subcutaneously under the patient's skin and is actuated by pressing its outer surface with a finger. This system is illustrated in FIGS. 58a-c. In FIG. 58a, a flexible subcutaneous standard reservoir 1013 is shown connected to a bulging servomotor reservoir 1050 by a conduit 1011. The bellows-shaped servomotor storage 1050 is formed in the flexible device 10. In the condition shown in FIG. 58a, the servo reservoir 1050 contains a minimum of fluid and most body fluids are found in the standard reservoir 1013. Due to the machine interconnection between the servo storage 1050 and the device 10, the outer shape of the device to which the 10 is is occupies less than its maximum capacity contracted for it. This maximum capacity is indicated by the dotted line in the figure.

FIG. 58b shows the standard reservoir 1013 in which the user is implanted in a patient-like device inside so that the fluid contained therein is brought into the flow through the conduit 1011 and into the servo reservoir 1050. Indicates to press. And it expands in the longitudinal direction due to its bellows shape. This deployment expands the device 10 one after another so that it occupies its maximum capacity. Thereby, the stomach wall (not shown) is stretched. And it makes it contact.

The standard storage section 1013 preferably comprises means 1013a for maintaining its shape after compression. When the user releases the standard reservoir, this means (schematically shown in the figure) also keeps the device 10 in the extended position in this way. In this way, the standard reservoir operates primarily as an intermittent switch for the system.

Another embodiment of hydraulic or air operation is currently described with respect to FIGS. 59 and 60ac. The block diagram shown in the figure consisting of a first closed system in which 59 controls a second closed system. The first system comprises a standard storage unit 1013 and a servo storage unit 1050. Servo storage 1050 controls a mechanically larger adjustable storage 1052 via machine interconnect 1054. An implanted device with an expandable / co-wisdom cavity in which 10 is controlled 1052 by a larger adjustable reservoir is a larger adjustable reservoir of fluid connection with device 10. It is supplied from the part 1052 in the working fluid.

Examples of this example are currently described with respect to FIGS. 60ac.
A standard reservoir, as in the previous embodiment, is a placed sub-skin under the patient's skin, and is activated by pressing its outer surface with a finger.
The standard reservoir 1013 is in a fluid connection with a bellows-shaped servomotor reservoir 1050 by conduit 1011. First closed system 1013, 1011, 1 shown in FIG. 60a
At 050, servo reservoir 1050 contains a minimum of fluid, and most body fluids are found in standard reservoir 1013.

Servo storage 1050 is mechanically connected to a larger adjustable storage 1052. And, in this example, it also has a bellows shape other than having a diameter considerably larger than that of the servo storage part 1050. The larger adjustable reservoir 1052 is in a fluid connection with device 10. When the user thereby transfers fluid from the standard reservoir 1013 to the servo reservoir 1050 and pushes the standard reservoir 1013, this is an adjustable reservoir 1052 with a larger deployment of the servo reservoir 1050. Means transferring a greater amount of fluid from to device 10. In other words, in this reversing servomotor, the smaller volume of the standard reservoir is compressed by a higher force, which causes a much greater total area change with less force per region device.

In the standard storage section 101, as described above in the above-described embodiment with respect to FIGS. 58a-c.
3 preferably comprises means 1013a for maintaining its shape after compression. When the user releases the standard reservoir, this means (schematically shown in the figure) is thus device 1
Keep 0 in the extended position. In this way, the standard reservoir operates primarily as an intermittent switch for the system.

It should be understood that even though the different parts described above have specific points on the drawing, these points may vary depending on the application.

The lubricating fluid used in any of the examples herein is preferably a biocompatible lubricating fluid that mimics the natural hip synovial fluid. According to one embodiment, the lubricating fluid is hyaluronic acid.

In all of the above examples, it is conceivable that the conduit is excluded and that the channel or channel is directly connected with a reservoir or injection port.
Note that any embodiment of the examples or parts may be combined in any way as well as parts of any method or method. All examples herein are to be viewed as part of a general description, and thus a candidate, that is generally combined in any form. Note that the general description should be considered to describe both the device and the method.

If this type of combination is clearly incompatible, the various features of the invention described above may be combined in any way.
The present invention is described in more detail with respect to the currently preferred embodiments and with respect to the accompanying drawings. Also, individual features of the various embodiments may be combined or exchanged, unless this type of combination or exchange is clearly compatible with the overall functioning of the device.

Claims (1)

A storage unit adapted to store the lubricating fluid, and
A fluid connection device consisting of a fluid connection tube (with the fluid connection):
a. Connected to the storage
b. Adapt to extend through the patient's tissue, and
c. A lubrication device is implanted in the patient to introduce the lubricating fluid in connection with the joint when planted. The joint has a body, a human or mammalian patient (lubrication consisting of the device). Implantable lubrication device that lubricates the joints of.

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